GMSIH, HPRIM and JAHIS

Integrating the Healthcare Enterprise

Laboratory
Technical Framework
10

Volume 2(LTF-2)
Transactions

20

Revision 1.2 –Final Text
February 27, 2005

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
Contents
1

INTRODUCTION....................................................................................................................................... 4
1.1

2

RATIONALE FOR THE CHOICE OF THE STANDARD TO BE USED ............................................................... 4

CONVENTIONS ......................................................................................................................................... 5
2.1
THE GENERIC IHE TRANSACTION MODEL............................................................................................ 5
2.2
HL7 PROFILING CONVENTIONS ............................................................................................................ 5
2.2.1
Static definition - message level...................................................................................................... 5
2.2.2
Static definition - segment level ...................................................................................................... 6
2.3
HL7 IMPLEMENTATION NOTES ............................................................................................................ 8
2.3.1
Network Guidelines......................................................................................................................... 8
2.3.2
Message Granularity ...................................................................................................................... 8
2.3.3
Acknowledgement Modes................................................................................................................ 8
2.3.4
ACK: General Acknowledgement Message .................................................................................... 8
2.3.5
IHE Laboratory Technical Framework acknowledgement policies................................................ 9
2.3.6
Identifier Data Types .................................................................................................................... 1030

2.3.6.1
2.3.6.2

40
3

COMMON MESSAGE SEGMENTS FOR LABORATORY TECHNICAL FRAMEWORK ......... 12
3.1
MSH - MESSAGE HEADER SEGMENT ................................................................................................. 12
3.2
MSA - MESSAGE ACKNOWLEDGEMENT SEGMENT ............................................................................. 15
3.3
ERR - ERROR SEGMENT ..................................................................................................................... 15
3.4
NTE - NOTES AND COMMENT SEGMENT ............................................................................................ 16
3.5
PID - PATIENT IDENTIFICATION SEGMENT ......................................................................................... 17
3.6
PV1 - PATIENT VISIT SEGMENT .......................................................................................................... 18
3.7
ORC COMMON ORDER SEGMENT ...................................................................................................... 19
3.8
TQ1 - TIMING QUANTITY SEGMENT .................................................................................................. 22
3.9
SPM - SPECIMEN SEGMENT ............................................................................................................... 23
3.10
SAC CONTAINER DETAIL SEGMENT .................................................................................................. 29
3.11
OBX - OBSERVATION/RESULT SEGMENT .......................................................................................... 30
3.12
CORRELATIONS OF STATUS BETWEEN ORC, OBR, OBX ................................................................... 34
3.12.1
Semantics of the main status code associations ....................................................................... 34
3.12.2
Status transition diagrams ....................................................................................................... 35

50

3.12.2.1
3.12.2.2
3.12.2.3

3.12.360

EI Data Type ....................................................................................................................................... 10
CX Data Type ..................................................................................................................................... 114

ORC-5: Order status ........................................................................................................................... 35
OBR-25: Order Result status .............................................................................................................. 35
OBX-11: Obsevation Result Status..................................................................................................... 36

Relationship between the 3 status fields................................................................................... 36

TRANSACTION LAB-1 : PLACER ORDER MANAGEMENT......................................................... 37
4.1
SCOPE................................................................................................................................................. 37
4.2
USE CASE ROLES................................................................................................................................ 37
4.3
REFERENCED STANDARDS .................................................................................................................. 38
4.4
INTERACTION DIAGRAMS .................................................................................................................... 38
4.4.1
Normal process of a placer order ................................................................................................. 39
4.4.2
Cancellation of an order by the Order Placer .............................................................................. 40
4.4.3
Cancellation of an order initiated by the Order Filler ................................................................. 40
4.5
MESSAGES STATIC DEFINITIONS ......................................................................................................... 41
4.5.1
Available HL7 2.5 structures for OML message........................................................................... 41
4.5.2
Restrictions on OML message for transaction LAB-1 .................................................................. 41
4.5.3
OML^O21 static definition............................................................................................................ 42
4.5.4
ORL^O22 static definition ............................................................................................................ 43
4.5.5
OML^O33 static definition............................................................................................................ 44
4.5.6
ORL^O34 static definition ............................................................................................................ 45
4.5.7
OML^O35 static definition............................................................................................................ 46
4.5.8
ORL^O36 static definition ............................................................................................................ 47
4.5.9
Specific segments description for transaction LAB-1 ................................................................... 48

70

4.5.9.1

5

OBR - Observation Request Segment ................................................................................................. 48

TRANSACTION LAB-2: FILLER ORDER MANAGEMENT ........................................................... 52

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Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
80

5.1
SCOPE................................................................................................................................................. 52
5.2
USE CASE ROLES................................................................................................................................ 52
5.3
REFERENCED STANDARDS .................................................................................................................. 52
5.4
INTERACTION DIAGRAMS .................................................................................................................... 53
5.4.1
Process of a filler order ................................................................................................................ 53
5.5
MESSAGES STATIC DEFINITIONS ......................................................................................................... 54
5.5.1
Available HL7 2.5 structures for OML message........................................................................... 54
5.5.2
Restrictions on OML message for transaction LAB-2 .................................................................. 54
5.5.3
OML and ORL messages static definition..................................................................................... 54
5.5.4
Specific segments description for transaction LAB-2 ................................................................... 54

90

5.5.4.1

6

OBR - Observation Request Segment ................................................................................................. 54

TRANSACTION LAB-3: ORDER RESULTS MANAGEMENT ........................................................ 57
6.1
SCOPE................................................................................................................................................. 57
6.2
USE CASE ROLES................................................................................................................................ 57
6.3
REFERENCED STANDARDS .................................................................................................................. 57
6.4
INTERACTION DIAGRAMS .................................................................................................................... 58
6.4.1
Normal process for management of results of a filler order......................................................... 58
6.4.2
Deletion of Battery/Test in a filler order ...................................................................................... 59
6.4.3
Addition of Battery/Test in a filler order ...................................................................................... 59
6.5
MESSAGES STATIC DEFINITIONS ......................................................................................................... 59
6.5.1
OUL : Unsolicited Laboratory Observation message................................................................... 59100

6.5.1.1
6.5.1.2

6.6
7

OUL^R22 static definition .................................................................................................................. 60
OUL^R24 static definition .................................................................................................................. 61

ACKNOWLEDGEMENT OF OUL MESSAGES ......................................................................................... 66

TRANSACTION LAB-4: WORK ORDER MANAGEMENT ............................................................. 67
7.1
SCOPE................................................................................................................................................. 67
7.2
USE CASE ROLES ................................................................................................................................. 67
7.3
REFERENCED STANDARDS .................................................................................................................. 67
7.4
INTERACTION DIAGRAMS .................................................................................................................... 67
7.5
MESSAGES STATIC DEFINITIONS ......................................................................................................... 68
7.5.1
Laboratory Order Message (OML^O21, ORL^O22) .................................................................... 68

110

7.5.1.1
7.5.1.2

7.5.2

Trigger events ..................................................................................................................................... 68
Message semantics.............................................................................................................................. 68

Laboratory Order for Multiple Orders Related to a Single Specimen (OML^O33, ORL^O34) ... 70

7.5.2.1
7.5.2.2

Trigger Events..................................................................................................................................... 70
Message semantics.............................................................................................................................. 70

7.5.3
Laboratory Order for Multiple Orders related to a Single Container of a Specimen (OML^O35,
ORL^O36) ................................................................................................................................................... 72
7.5.3.1
7.5.3.2
7.5.3.3

120
8Trigger Events..................................................................................................................................... 72
Message Semantics ............................................................................................................................. 72
Expected Action.................................................................................................................................. 76

TRANSACTION LAB-5: TEST RESULTS MANAGEMENT ............................................................ 77
8.1
SCOPE................................................................................................................................................. 77
8.2
USE CASE ROLES ................................................................................................................................. 77
8.3
REFERENCED STANDARDS .................................................................................................................. 77
8.4
INTERACTION DIAGRAMS .................................................................................................................... 77
8.5
MESSAGES STATIC DEFINITIONS ......................................................................................................... 78
8.5.1
Trigger Events .............................................................................................................................. 78
8.5.1.1
8.5.1.2
8.5.1.3
8.5.1.4
8.5.1.5
8.5.1.6

130

9Message semantics (R22).................................................................................................................... 78
Message semantics (R23).................................................................................................................... 79
Message semantics (R24).................................................................................................................... 80
Expected Action.................................................................................................................................. 81
OBR segment...................................................................................................................................... 81
TCD segment ...................................................................................................................................... 82

REAL WORLD USE CASES................................................................................................................... 83
9.1
9.2

GUIDELINES........................................................................................................................................ 83
TWO HEMATOLOGY BATTERIES ON A BLOOD SPECIMEN ..................................................................... 84

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9.2.1
9.2.2
9.2.3

140

Storyboard .................................................................................................................................... 84
Interaction diagram ...................................................................................................................... 85
Messages....................................................................................................................................... 85

9.2.3.1
9.2.3.2
9.2.3.3
9.2.3.4
9.2.3.5
9.2.3.6
9.2.3.7

LAB-1 (OP  OF)
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LAB-4 (OF  AM)
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LAB-1 (OF  OP)
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LAB-3 (OF->ORT)
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”....................................................................................... 86
LAB-5 (AM->OF)
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”...................................................................................... 87
LAB-1 (OF->OP)
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................................................................................... 87
LAB-3 (OF->ORT)
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9.3
TEST ON A SERIES OF SPECIMENS: GLUCOSE TOLERANCE STUDY....................................................... 89
9.3.1
Storyboard .................................................................................................................................... 89
9.3.2
Interaction diagram ...................................................................................................................... 91
9.3.3
Messages....................................................................................................................................... 91

150

9.3.3.1
9.3.3.2
9.3.3.3
9.3.3.4
9.3.3.5
9.3.3.6
9.3.3.7
9.3.3.8
9.3.3.9
9.3.3.10
9.3.3.11
9.3.3.12
9.3.3.13
9.3.3.14

160

LAB-1 (OP  OF)
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............................................... 91
LAB-4 (OF  AM)
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ns............................................. 92
LAB-1 (OF  OP)
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....................................... 92
LAB-3 (OF  ORT)
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............................................ 92
LAB-5 (AM OF)
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LAB-1 (OF  OP)
:Me
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LAB-3 (OF  ORT)
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LAB-1(OP  OF)
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”............................................................ 94
LAB-4 (OF  AM)
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LAB-1 (OF  OP)
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.................................................. 94
LAB-3 (OF  ORT)
:Me
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LAB-5 (AM OF)
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LAB-1 (OF  OP)
:Me
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LAB-3 (OF  ORT)
:Me
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9.4
BATTERY WITH 2 SPECIMENS: CREATININE CLEARANCE .................................................................... 97
9.4.1
Storyboard .................................................................................................................................... 97
9.4.2
Interaction diagram ...................................................................................................................... 98
9.4.3
Messages....................................................................................................................................... 99
9.4.3.1
9.4.3.2
9.4.3.3
9.4.3.4
9.4.3.5
9.4.3.6
9.4.3.7

170

LAB-1 (OP  OF)
:Me
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LAB-4 (OF  AM)
:Me
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”....................................................................................... 99
LAB-1 (OF  OP)
:Me
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LAB-3 (OF->ORT)
:Me
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”..................................................................................... 100
LAB-5 (AM->OF)
:Me
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LAB-1 (OF->OP)
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................................................................................. 100
LAB-3 (OF->ORT)
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9.5
MICROBIOLOGY WITH TWO SPECIMENS AND THREE GERMS IDENTIFIED ........................................... 102
9.5.1
Storyboard .................................................................................................................................. 102
9.5.2
Interaction diagram .................................................................................................................... 104
9.5.3
Messages..................................................................................................................................... 105

180

9.5.3.1
9.5.3.2
9.5.3.3
9.5.3.4
9.5.3.5
9.5.3.6
9.5.3.7
9.5.3.8
9.5.3.99.5.3.10
9.5.3.11
9.5.3.12

190

LAB-1 (OP  OF)
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...................................................... 105
LAB-1 (OF  OP)
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LAB-3 (OF  ORT)
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LAB-1 (OF  OP)
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LAB-3 (OF  ORT)
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LAB-2(OF  OP)
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LAB-3 (OF  ORT)
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............................................................................ 107
LAB-1 (OF  OP)
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LAB-2(OF  OP): Messag
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LAB-3 (OF  ORT)
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............................................................................ 109
LAB-1 (OF  OP)
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LAB-3 (OF  ORT)
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10RELATIONSHIP BETWEEN TRANSACTIONS AND MESSAGES/TRIGGER EVENTS.......... 112

11

OUTSTANDING ISSUES ...................................................................................................................... 118

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1 Introduction
This document is Volume 2 of "IHE Laboratory Technical Framework".
Volume 1 provides the high-level view of this framework, describes the Integration Profiles,
defines the Actors and shows the sequencing of transactions between them.
200

This document, Volume 2, provides the detailed description of each new transaction
introduced by the Laboratory Technical Framework: Roles of the actors, trigger events,
messages exchanged, standards employed, triggered actions.

1.1 Rationale for the choice of the standard to be used
For the new messages defined in this Volume 2 the possible standards considered were:HL7 V3
HL7 V2.3.1
HL7 V2.4

HL7 V2.5

210

At this point in time, HL7 V3 is not ready for implementation in systems, and HL7 V2.5 isthe only available version that supports both specimen and container. Moreover, domain
experts view it as the best available version for the laboratory profile.
For this reason the IHE Laboratory committee has chosen to base this volume on HL7 V2.5.
The Laboratory Technical Framework uses two transactions that have already been defined in
the Radiology Technical Framework: "Patient Registration [1]" and "Patient Update [12]".
These two transactions are adopted without change, with their messages using HL7 V2.3.1.
They are not described in this document, and the reader is referred to the "Radiology
Technical Framework Volume 2". However, the transaction "Patient Update [12]" triggers a
specific action from the Order Filler that sends a specific message of transaction LAB-4 to
the Automation Manager (See chapter 7 of this document).

220

Since we have at least two transactions using the pipe encoding mechanism, this encoding
mechanism is required for the messages described in this volume. The XML encoding ofthese messages is optional and may be specified in national extensions.

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2 Conventions
2.1 The generic IHE Transaction Model
See the "IHE Radiology Technical Framework" Volume 2, chapter 2.1

2.2 HL7 Profiling Conventions

230

The messages used by each transaction are described in this document using static definitionsof "HL7 constrainable message profiles". Refer to HL7 v2.5 section 2.12.6. The static
definition of each message is represented within tables. At the message level, a table
represents the message structure and its definition in terms of segments. At the segment level,a table details one segment and its definition in terms of fields.
2.2.1 Static definition - message level
The table describing a message contains 5 columns:
Segment: gives the segment name, and places the segment within the hierarchy of themessage, as designed by HL7: i.e. delimiting optional segments with square brackets,and repeatable segments with braces, and using indentation to show the hierarchy.
Meaning: Meaning of the segment as defined by HL7Usage: Coded usage of the segment, as defined by this static definition built for thecontext of this particular transaction within IHE Laboratory Technical Framework.
The coded values used in this document are:

240

250

R: Required: A compliant sending application shall populate all "R" elementswith a non-empty value. A compliant receiving application shall process(save/print/archive/etc.) or ignore the information conveyed by requiredelements. A compliant receiving application shall not raise an error due tothe presence of a required element, but may raise an error due to the absenceof a required element.
RE: Required but may be empty. The element may be missing from the message,
but shall be sent by the sending application if there is relevant data. A
conformant sending application shall be capable of providing all "RE"elements. If the conformant sending application knows the required values
for the element, then it shall send that element. If the conformant sending
application does not know the required values, then that element may beomitted.
Receiving applications will be expected to process (save/print/archive/etc.)
or ignore data contained in the element, but shall be able to successfully
process the message if the element is omitted (no error message should be
generated if the element is missing).
O: Optional. The usage for this field within IHE Laboratory Technical
Framework has not been defined yet

260

C: Conditional. This usage has an associated condition predicate. (See HL7 v2.5
section 2.12.6.6 "Condition Predicate").

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Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
If the predicate is satisfied: A compliant sending application shall always
send the element. A compliant receiving application shall process or ignore
data in the element. It may raise an error if the element is not present.
If the predicate is NOT satisfied: A compliant sending application shall NOT
send the element. A compliant receiving application shall NOT raise anerror if the condition predicate is false and the element is not present, though
it may raise an error if the element IS present.

270

X: Not supported. For conformant sending applications, the element will not be
sent. Conformant receiving applications may ignore the element if it is sent,
or may raise an application error.
Cardinality: Within square brackets, minimum and maximum number of occurrences
authorized for this segment, in this static definition of the message, built for thecontext of this particular transaction within IHE Laboratory Technical Framework.
HL7 chapter: Reference of the HL7 v2.5 chapter that describes this segment.
Simplification:
Forabe
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hownat the message level: if asegment is "not supported" by an IHE profile, it simply doesn't appear in the table
representing the message structure.
280
Table 3.2-1: Example: Initial segments of a message description
Segment

Meaning

MSH

Message Header[--- PATIENT begin
PID

Patient Identification[--- PATIENT VISIT begin
PV1

Patient Visit

Usage

Card.

HL7 chapter

R[1..1]

2[1..1]
R[1..1]

3[1..1]
RE[0..1]

3

2.2.2 Static definition - segment level290

The table describing a segment and its definition in terms of fields contains 7 columns :SEQ: Position (sequence) of the field within the segment.
LEN: Maximum length of the fieldDT: Field Data TypeUsage: Usage of the field in this particular context of IHE Laboratory Technical
Framework. Same coded values as in the message level: R, RE, C, O, X
Cardinality: Minimum and maximum number of occurrences for the field in thisparticular context of IHE Laboratory Technical Framework. Same meaning as in themessage level.
TBL#: Table reference (for fields using a set of defined values)
ITEM#: HL7 unique reference for this field

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Element Name: Name of the field.
Simplification :Forabe
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yoft
het
a
bl
e
,t
heus
a
ge“
O"i
snots
hownat the segment level: Alloptional fields doooo not appear in the tables. The number in the first column SEQ is the
only item of information that provides the exact position of a field within this segment.

Table 3.2-2: Example: The MSH segment description
SEQ

LEN

DT

Usage

Card.

ITEM#

Element name

1

1

ST

R

[1..1]

TBL#

00001

Field Separator

2

4

ST

R

[1..1]

00002

Encoding characters

3

227

HD

R

[1..1]

00003

Sending Application

0361

…

300
According to HL7 standard, if the value of a field is not present, the receiver shall notchange corresponding data in its database. However, if the sender defines the field value
to be the explicit NULL value (i.e. two double quotes ""), it shall cause removal of any
values for that field in the receiver's database. This convention is fully applied by the
Laboratory Technical Framework.

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2.3 HL7 Implementation Notes
2.3.1 Network Guidelines
The IHE Laboratory Technical Framework makes these recommendations:
310

Applications shall use the Minimal Lower Layer Protocol (MLLP) defined in appendix C of
the HL7 Implementation Guide.
An application that wants to send a message (initiate a transaction) will initiate a network
connection (if one does not already exist) to start the transaction. The receiver application
will respond with an acknowledgement or response to query but will not initiate newtransactions on this network connection.
2.3.2 Message Granularity
A message is generated from one trigger event in the real world. Therefore a message isrelated to one single order or to one order group:
A LAB-1 message is related to one placer order or to one placer order group.

320

A LAB-2 message is related to one filler order or to one filler order group.
A LAB-3 message is related to one (filler and placer) order or to one order group.
A LAB-4 or a LAB-5 message is related to one work order.
2.3.3 Acknowledgement Modes
For this cycle of the IHE Laboratory Technical Framework, applications that receive HL7
messages shall send acknowledgements using the HL7 original acknowledgement mode as
defined in HL7 v2.5 chapter 2, 2.9.2. The enhanced acknowledgement rules are not supported.

330

An OML message shall be acknowledged by one single ORL message. An OUL message
shall be acknowledged by one single ACK message. These acknowledgements areapplication-level acknowledgements (i.e. not transport acknowledgements) and must be
generated by the receiving application after it has parsed the message and processed its
content.
The receiving application shall automatically generate the application-level
acknowledgement messages without waiting for human approval of the contents of themessage that was received.
2.3.4 ACK: General Acknowledgement Message
This message is defined in HL7 chapter 2
Table 3.3-1: ACK: General Acknowledgement Message
Segment

340

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

MSA

Message AcknowledgementR[1..1]

2[{ERR}]

Error

C[0..1]

2

Notes: For the general acknowledgment (ACK) message, the value of MSH-9-2-Trigger event is equal to thevalue of MSH-9-2-Trigger event in the message being acknowledged. The value of MSH-9-3Message structure for the general acknowledgment message is always ACK.

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The Condition Predicate for using an ERR segment is specified in the transaction chapters.

2.3.5 IHE Laboratory Technical Framework acknowledgement policies
From a transactional viewpoint a MLLP (Minimal Lower Layer Protocol) network
connection is unidirectional. Event-triggered messages flow in one direction andacknowledgement messages related to those event-triggered messages flow in the otherdirection.
350

The acknowledgement message to an event-triggered message shall be sent immediately tothe sender on the same MLLP connection that carried the event-triggered message. The
receiver of an event-triggered message should assume that the sending application is blocking
and send an application-level acknowledgement as soon as possible.
It may take the receiving system a while (seconds, minutes) to acknowledge a message. If the
MLLP connection is broken whilst the sending application is still waiting for an
acknowledgement, the sending application shall initiate a new MLLP connection and resend
the message.

360

The acknowledgement message is an application-level acknowledgement. (Note: HL7
commit/accept acknowledgement messages shall not be used). The application
acknowledgement shall only be created by an application that is able to examine a message at
the semantic / business-proces level. Intermediate message brokers do not have this capacity
and therefore shall not be used to generate the contents of application acknowledgements.

Usage of network connections
Trigger events in one Application

Trigger
event

Actor
application
Acknowledgement
ORL or ACK

Initiates network
connection
Sends MLLP block
Waits for response

Actorapplication
Message
OML or OUL

Initiating
moduleMessage
OML or OUL<SB>message<EB><CR>

Acknowledgement
ORL or ACK

Acceptingmodule<SB>answer<EB><CR>

Transactions between 2 applications which contain trigger events on both sides (such as
LAB-1) require at least two network connections between the Actors, one for each direction:Rev. 1.1–Final Text 08/07/2004

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Usage of network connections
Trigger events in both Applications
New order
enteredTrigger
event

Order statuschangeOrder Placer

Trigger
event

Order Filler
OML^NW

ORL^OKOML^NW

ORL^OKOML^SCORL^OK

Initiating
moduleORL^OK<SB>OML^NW<EB><CR>

Acceptingmodule<SB>ORL^OK<EB><CR><SB>OML^SC<EB><CR>

Acceptingmodule<SB>ORL^OK<EB><CR>OML^SC

Initiating
module370

2.3.6 Identifier Data Types
This section describes the IHE constraints of the data types.
2.3.6.1 EI Data TypeThe constraints below particularly apply to the following fields: placer group number, placer
order number, filler order number and specimen number.

380

SEQ

LEN

DT

1
2
3
4

16
20
199
6

ST
IS
ST
ID

Usage
R

CARD

TBL#

[1..1][0..1][0..1][0..1]

C
C

C

0363
0301

COMPONENT NAME

Entity IdentifierNamespace ID
Universal ID
Universal ID Type

Component 1 is required. Either component 2 or both components 3 and 4 are required.
Components 2, 3 and 4 may be all present.
The EI is appropriate for machine or software generated identifiers. The generated identifiergoes in the first component. The remaining components, 2 through 4, are known as theassigning authority; they can also identify the machine/system responsible for generating theidentifier in component 1.
Example 1: AB12345^RiversideHospital
Example 2: AB12345^^1.2.840.45.67^ISO
Example 3: AB12345^RiversideHospital^1.2.840.45.67^ISO

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IHE restrains the length of the first component to 16 characters. National extensions can
extend this length up to a maximum of 199.
I
HEr
e
c
omma
ndst
of
i
l
lc
ompone
nt2“
Na
me
s
pa
c
eI
D”i
na
l
lc
a
s
e
s
.Pa
r
t
i
c
ul
a
r
l
ywhe
nt
he
r
e
are several concurrent assigning authorities within the healthcare enterprise, this Namespace
ID will indicate which assigning authority provided this number.
This happens for instance, when there are several Order Placer actors within the enterprise,each one assigning placer order numbers and placer group numbers.
Example 4: Placer order number 9876543 and placer group number 777 assigned by theOrder Placer actor operated by the Nephrology department.
ORC|NW|9876543^Nephro||777^Nephro|...

400

Example 5: Placer order number 9876543 and placer group number 555 assigned by theOrder Placer actor operated by the Urology department.
ORC|SC|9876543^Urology||555^Urology |...

This also commonly happens when there are several Order Filler actors within the enterprise,each one assigning its own filler order numbers and specimen numbers.
Example 6: Filler order number and specimen number assigned by the Order Filler actor
operated by the clinical laboratory of cytology.
SPM|1|45611^Cytology|...
...
OBR|1|456^Cytology|...

2.3.6.2 CX Data Type410

The constraints below particurarly apply to the Patient Identifiers (PID segment).
SEQ

LEN

DT

Usage

CARD

1
2
3
4
5
6
7
8
9
10

15
1
3
227
5
227
8
8
705
705

ST
ST
ID
HD
ID
HD
DT
DT
CWE
CWE

R
O
O
R
RE
O
O
O
O
O

[1..1][0..1][0..1][1..1][0..1][0..1][0..1][0..1][0..1][0..1]

TBL#

0061
0363
0203

COMPONENT NAME

ID Number
Check Digit
Check Digit Scheme
Assigning Authority
Identifier Type Code
Assigning Facility
Effective Date
Expiration Date
Assigning Jurisdiction
Assigning Agency or
Department

The data type has been constrained because the IHE Framework regards the Assigning
Authority and the Identifier Type Code as essential components. The most common value for
the Identifier Type Code in PID-3i
s“
PI
”
.Ot
he
rva
l
ue
sa
r
ede
f
i
ne
di
nTa
bl
e0203ofHL72.
5
section 2.A.14.5.
Example: 12345^^^Saint-John Hospital^PI

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3 Common Message Segments for Laboratory Technical
Framework
420

This section describes the common message segments used by the transactions LAB-1, LAB2, LAB-3, LAB-4, LAB-5.
Each table represents a segment. Below the table are commented only the fields for which
IHE Laboratory Technical Framework brings some precision on usage. The optional fields
are not shown in the table, unless they require a particular comment within the context of the
IHE Framework.

3.1 MSH - Message Header Segment
HL7 v2.5: chapter 2 (2.15 Message control)
This segment defines the intent, source, destination, and some specifics of the syntax of amessage.
430

Table 3.1-1 : MSH - Message Header
SEQ

LEN

DT

Usage

Card.

TBL#

1

1

SI

R

[1..1]

00001

Field Separator

2

4

ST

R

[1..1]

00002

Encoding Characters

3

227

HD

R

[1..1]

00003

Sending Application

4

227

HD

R

[1..1]

00004

Sending Facility

5

227

HD

R

[1..1]

00005

Receiving Application

6

227

HD

R

[1..1]

00006

Receiving Facility

7

26

TS

R

[1..1]

00007

Date/Time of Message

8

40

ST

X

[0..0]

00008

Security

9

15

MSG

R

[1..1]

00009

Message Type

10

20

ST

R

[1..1]

00010

Message Control Id

11

3

PT

R

[1..1]

00011

Processing Id

12

60

VID

R

[1..1]

00012

Version ID

14

180

ST

X

[0..0]

00014

Continuation Pointer

15

2

ID

X

[0..0]

0155

00015

Accept Acknowledgement Type

16

2

ID

X

[0..0]

0155

00016

Application Acknowledgement Type

17

3

ID

RE

[1..1]

0399

00017

Country Code

18

16

ID

C

[0..1]

0211

00692

Character Set

19

250

CE

RE

[1..1]

00693

Principal Language of Message

20

20

ID

X

[0..0]

01317

Alternate
Scheme

21

427

EI

RE

[0..*]

01598

Message Profile Identifier

0356

ITEM#

Element nameCharacter

Set

Handling

MSH-1 Field Separator, required: The IHE Laboratory Technical Framework requires thatapplications support HL7-recommended value that is | (ASCII 124).
MSH-2 Encoding Characters, required: This field contains the four characters in thefollowing order: the component separator, repetition separator, escape character, andsubcomponent separator. The IHE Laboratory Technical Framework requires that

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applications support HL7-recommended values ^~\&
respectively).

(ASCII 94, 126, 92, and 38,

MSH-4 Sending Facility (HD), required:
440

Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>The IHE Laboratory Technical Framework requires that this field be populated with:First component (required): Namespace ID. The name of the organizational entity responsible
for the sending application.
Second component (optional): The URI (OID) of the organizational entity responsible for thesending application.
Third component (optional): The type of identification URI provided in the second
component of this field. The codification of these three components is entirely site-defined. It
may be detailed in the national extensions of this framework.
MSH-6 Receiving Facility (HD), required:

450

Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>The IHE Laboratory Technical Framework requires that this field be populated with:First component (required): Namespace ID.
responsible for the receiving application.

The name of the organizational entity

Second component (optional): The URI (e.g. OID) of the organizational entity responsible forthe receiving application.
Third component (optional): The type of identification URI provided in the second
component of this field. The codification of these three components is entirely site-defined. It
may be detailed in the national extensions of this framework.
MSH-9 Message Type (MSG), required:
460

Components: <Message Code (ID)> ^ <Trigger Event (ID)> ^ <Message Structure (ID)>Definition: This field contains the message type, trigger event, and the message structure ID
for the message. All three components are required.
Its content is defined within each transaction-specific section of this document.
MSH-10 Message Control Id (ST), required:
Definition: This field contains a number or other identifier that uniquely identifies themessage. Each message should be given a unique identifier by the sending system. The
receiving system will echo this ID back to the sending system in the Message
Acknowledgment segment (MSA). The combination of this identifier and the name of thesending application (MSH-3) should be unique across the Healthcare Enterprise.

470

MSH-12 Version ID (VID), required:
Components: <Version ID (ID)> ^ <Internationalisation Code (CE)> ^ <International
Version ID (CE)>Definition: This field is matched by the receiving system to its own version to be sure themessage will be interpreted correctly.
The IHE Laboratory Technical framework requires the first component to be populated withthe value "2.5" representing HL7 release 2.5.

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MSH-15 Accept Acknowledgment Type (ID), not supported: IHE uses only the HL7
original acknowledgement mode.
MSH-16 Application Acknowledgment Type (ID), not supported for the same reason.
480

MSH-17 Country Code (ID), required if available.
Definition: This field contains the country of origin for the message. The values to be used
are those of ISO 3166, with the 3-character (alphabetic form). Refer to HL7 Table 0399 Country code
Examples of valid values:
JPN = Japan, USA = United States, GBR = United Kingdom, ITA = Italy, FRA = France,
NLD = Netherlands.
MSH-18 Character Set (ID), conditional.
Definition: This field contains the character set for the entire message. Refer to HL7 table0211 - Alternate character sets for valid values.

490

Examples of valid values:
ASCII: The printable 7-bit ASCII character set.
8859/1: The printable characters from the ISO 8859/1 Character set used by Western Europe.
This character set can still be used, but 8859/15 should be used by preference. This character
set is the forward-compatible version of 8859/1 and includes new characters such as the Euro
currency symbol.
ISO IR87: Code for the Japanese Graphic Character set for information interchange (JIS X
0208-1990).
UNICODE UTF-8: UCS Transformation Format, 8-bit form.

500

Condition predicate: This field shall only be valued if the message uses a character set otherthan the 7-bit ASCII character set. Though the field is repeatable in HL7, IHE authorizes only
one occurrence (i.e. one character set). The character set specified in this field is used for theencoding of all of the characters within the message.
MSH-19639.

Principal Language of Message (CE), required if available. Coded from ISO

Examples: DE = German, EN = English, ES=Spanish, JA = Japanese, FR = French, NL =Dutch, IT = ItalianMSH-20 Alternate Character Set Handling Scheme (ID), not supported: Character set
switching is not allowed in the IHE Laboratory Technical Framework.
MSH-21 Message Profile Identifier (EI), Required if available.
510

For IHE Laboratory Technical Framework, this field shall only be valued in the messages forwhich a Message Profile has been officially defined and identified. When multiple message
profiles are listed in this field they should be (vendor specific, country specific) constraints of
the IHE Laboratory Profile. Note that the overriding of IHE Laboratory Profile constraints isonly allowed in national extensions to this framework.

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3.2 MSA - Message Acknowledgement segment
HL7 v2.5: chapter 2 (2.15 Message control)
This segment contains information sent while acknowledging another message.
520

Table 3.2-1: MSA - Message Acknowledgement
SEQ

LEN

DT

Usage

Card.

TBL#

ITEM#

1

2

ID

R

[1..1]

0008

00018

Acknowledgement code

2

20

ST

R

[1..1]

00010

Message Control Id

3

80

ST

X

[0..0]

00020

Text Message

X[0..0]

00022

Delayed Acknowledgment TypeX

[0..0]

00023

Error Condition

5
6

250

CE

0357

Element name

MSA-1 Acknowledgment Code (ID), required.
The IHE Laboratory Technical Framework authorizes only one of the three values below,
taken from HL7 table 0008 - Acknowledgement code:
Table 3.2-2: HL7 table 0008 - Acknowledgement code
Value

Description

Comment

mode:

The message has been accepted and integrated by the receiving
applicationAA

Original
AcceptApplication

AE

Original mode: Application Error

The sender should try again to send the message later

AR

Original
Reject

The message has been rejected by the receiving application

mode:

Application

MSA-2 Message Control ID (ST), required.
Definition: This field contains the message control ID from the MSH-10 - Message Control
ID of the incoming message for which the acknowledgement is sent.
530

MSA-3 Text Message (ST), not supported. See the ERR segment.

3.3 ERR - Error segment
HL7 v2.5 : chapter 2 (2.15 Message control)
This segment is used to add error comments to acknowledgment messages.
Table 3.3-1: ERR –Error segment
SEQ

LEN

DT

Usage

Card.

1

493

ELD

X

[0..0]

3

705

CWE

R

[1..1]

4

2

ID

R

[1..1]

TBL#

ITEM#

Element name00024

Error Code and Location

0357

01813

HL7 Error Code

0516

01814

Severity

Notes: ERR-1 is included in HL7 v2.5 for backward compatibility only. Within the context of the laboratory, thisfield shall not be used.
ERR-3 and ERR-4 are required by HL7 v2.5

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540

3.4 NTE - Notes and Comment segment
HL7 v2.5 : chapter 2 (2.15 Message control)
This segment is used for sending notes and comments.
The IHE Laboratory Technical Framework limits the use of this segment to only one purpose:
To comment the observations and the orders. Therefore, in the messages of this Integration
Profile, NTE segments appear only below OBR or OBX segments.
Information that can be coded in OBX segments or OBR segments shall not be sent in a NTE
segment.
Table 3.4-1: NTE - Notes and Comment segment

550

SEQ

LEN

DT

Usage

Card.

TBL#

ITEM#

Element name

1

4

SI

R

[1..1]

00096

Set ID –NTE

2

8

ID

RE

[0..1]

00097

Source of Comment

3

65536

FT

RE

[0..1]

00098

Comment

4

250

CE

RE

[0..1]

01318

Comment Type

NTE-1 Set ID - NTE (SI), required.
NTE-2 Source of Comment (ID), required but may be empty.
IHE Laboratory Technical Framework populates this field with one of these values:
Table 3.4-2 : Source of Comment
Value

Meaning

L

Order Filler is the source of the comment

P

Order Placer is the source of the comment

A

Automation Manager is the source of the commentO

Other system is the source of the comment

Comment

NTE-3 Comment (FT), required but may be empty: This field contains the text of thecomment. This text may be formatted. In order to delete an existing comment, the field shall
c
ont
a
i
ne
mpt
yquot
a
t
i
onma
r
ks
:“ ”.
Comment text of identical type and source shall be included in the same occurrence of an
NTE segment, and not be split over multiple segments.
560

NTE-4 Comment Type (CE), required if known.
The IHE Laboratory Technical Framework populates this field with one of these values:
Table 3.4-3 : Comment Type
Value

Meaning

Comment

I

Internal remark, that shall not be sent
outside of the laboratory

Used between Automation Manager and Order Filler. Shallnot be sent to the Order Result Tracker

C

Comment addressed to medical staff andphysician,Should be sent to the Order Result Tracker or the Order
Placer, but should not be showed to the patientP

Comment addressed to medical staff andphysician, may be showed to the patient

Should be sent to the Order Result Tracker or the Order
Placer, and may appear on the result report addressed to thepatient.

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3.5 PID - Patient Identification segment
HL7 v2.5 : chapter 3 (3.4.2)
The PID segment is used by all applications as the primary means of communicating patient
identification information. This segment contains permanent patient identifying anddemographic information that, for the most part, is not likely to change frequently.
Table 3.5-1 : PID - Patient Identification segment

570

SEQ

LEN

DT

Usage

Card.

TBL#

1

4

SI

O

[1..1]

00104

Set ID - PID

2

20

CX

X

[0..1]

00105

Patient ID

3

250

CX

R

[1..*]

00106

Patient Identifier List

4

20

CX

X

[0..1]

00107

Alternate Patient ID - PID

5

250

XPN

R

[1..*]

00108

Patient Name

6

250

XPN

O

[0..1]

00109

Mot
he
r
’
sMa
i
de
nNa
me

7

26

TS

RE

[0..1]

00110

Date/Time of Birth

8

1

IS

R

[1..1]

00111

Administrative Sex

9

250

XPN

X

[0..1]

00112

Patient Alias

10

250

CE

RE

[0..1]

00113

Race

11

250

XAD

RE

[0..*]

00114

Patient Address

12

4

IS

X

[0..1]

00115

County Code

13

250

XTN

O

[0..*]

00116

Phone Number - Home

14

250

XTN

O

[0..*]

00117

Phone Number - Business

15

250

CE

O

[0..1]

0296

00118

Primary Language

16

250

CE

O

[0..1]

0002

00119

Marital Status

17

250

CE

O

[0..1]

0006

00120

Religion

18

250

CX

RE

[0..1]

00121

Patient Account Number

19

16

ST

X

[0..1]

00122

SSN Number - Patient

20

25

DLN

X

[0..1]

00123

Driver's License Number - Patient

21

250

CX

O

[0..*]

00124

Mother's Identifier

22

250

CE

O

[0..1]

00125

Ethnic Group

23

250

ST

O

[0..1]

00126

Birth Place

24

1

ID

O

[0..1]

00127

Multiple Birth Indicator

25

2

NM

O

[0..1]

00128

Birth Order

26

250

CE

O

[0..1]

0171

00129

Citizenship

27

250

CE

O

[0..1]

0172

00130

Veterans Military Status

28

250

CE

X

[0..0]

0212

00739

Nationality

29

26

TS

O

[0..1]

00740

Patient Death Date and Time

30

1

ID

O

[0..1]

0136

00741

Patient Death Indicator

31

1

ID

RE

[0..1]

0136

01535

Identity Unknown Indicator

32

20

IS

RE

[0..1]

0445

01536

Identity Reliability Code

35

250

CE

C

[0..1]

0446

01539

Species Code

36

250

CE

C

[0..1]

0447

01540

Breed Code

0001
0005
0289

0189
0136

ITEM#

Element name

The specific usage of these fields, especially those fields with usage " O " (optional) in thetable above, is explained in the national extensions.

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PID-7: if the exact date of birth is not known, the second component of this field can be used
to describe the degree of precision of the information entered in the first component.
PID-18: The use of the Patient Account Number may be related to the Visit Number (PV119). Generally, one of both fields will be filled. Additional requirements for these fields may
be documented in Regional or National appendices to the IHE Laboratory Technical
Framework.
PID-35, PID-36:
Condition predicate: shall be used if the test subject is a non-human living subject.
580

3.6 PV1 - Patient Visit segment
HL7 v2.5: chapter 3 (3.4.3)
The PV1 segment is used by Registration/Patient Administration applications tocommunicate information on an account or visit-specific basis.
Table 3.6-1: PV1 - Patient Visit segment
SEQ

LEN

DT

Usage

2

1

IS

R

[1..1]

Card.

TBL#

ITEM#

0004

00132

Patient Class

3

80

PL

RE

[0..1]

9

250

XCN

X

[0..0]

19

250

CX

RE

[0..1]

00133

Assigned Patient Location

00139

Consulting Doctor

00149

Visit Number

40

1

IS

X

[0..0]

0116

00170

Bed Status

51

1

IS

C

[0..1]

0326

01226

Visit Indicator

52

250

XCN

X

[0..0]

0010

01274

Other Healthcare Provider

0010

Element name

The specific usage of these fields may be elaborated upon in the national extensions.

590

The use of the Visit Number (PV1-19) may be related to the Patient Account Number (PID18). Generally, one of both fields will be filled. Additional requirements for these fields may
be documented in Regional or National appendices to the IHE Laboratory Technical
Framework.
Field PV1-51 shall be valued with value 'V' if the field PV1-19 is present. The field may beomitted otherwise.
ThePV1s
e
g
me
ntdoe
s
n’
te
nt
i
r
e
l
yc
ove
rt
heda
t
amode
la
sde
f
i
ne
di
nt
hi
sf
r
a
me
wor
k.I
n
some countries (especially in Europe), national extensions will define new segment to
ma
na
g
ei
s
s
ue
sl
i
ke‘
f
unc
t
i
ona
luni
t
s
’
.
The use of the PV1 segment shall be clarified in each national extension.

Rev. 1.1–Final Text 08/07/2004

18

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

3.7 ORC Common Order Segment

600

HL7 v2.5: chapter 4 (4.5.1). The ORC and OBR segments contain a number of duplicate
fields. The Laboratory Technical Framework is defined is such a way that fields in the OBR
segment will be used in prevalence over their equivalents in ORC. If a field is listed as being
optional in ORC, its equivalent in OBR may well be mandatory.
Table 3.7-1 : ORC Segment
SEQ

LEN

DT

Usage

Card.

TBL#

ITEM#

1

2

ID

R

[1..1]

0119

00215

Order Control

2

22

EI

C

[0..1]

00216

Placer Order Number

3

22

EI

C

[0..1]

00217

Filler Order Number

4

22

EI

RE

[0..1]

00218

Placer Group Number

5

2

ID

C

[0..1]

00219

Order Status

7

200

TQ

X

[0..0]

00221

Quantity/Timing

8

200

EIP

X

[0..0]

00222

Parent

9

26

TS

R

[1..1]

00223

Date/Time of Transaction

10

250

XCN

RE

[0..*]

00224

Entered By

11

250

XCN

RE

[0..*]

00225

Verified By

17

250

CE

RE

[0..1]

00231

Entering Organization

20

250

CE

X

[0..0]

01310

Advanced Beneficiary Notice Code

21

250

XON

RE

[0..1]

01311

Ordering Facility Name

25

250

CWE

X

[0..0]

01473

Order Status Modifier

26

60

CWE

X

[0..0]

01641

Advanced Beneficiary Notice Override
Reason

27

26

TS

C

[0..1]

01642

Filler's
Expected
Date/Time

0038

0339

0552

Element name

Availability

ORC-1 Order Control (ID), required. This field may be considered the "trigger event"identifier for orders. Many order control codes are defined in the HL7 table 0119 –Order
Control Codes. The IHE Laboratory Technical Framework allows only the following subset:
Table 7.4.1.2.4-1: Supported Order Control Code
Value

Description of use

NW

“
Ne
w Or
de
r
”
.Event request in OML message sent by the Order Placer in transaction LAB-1 or in OML
message sent by the Order Filler in transaction LAB-4.

OK

“
Not
i
f
i
c
a
t
i
onorr
e
q
ue
s
ta
c
c
e
pt
e
d”
.Ev
e
ntn
ot
i
f
i
c
a
t
i
oni
nOMLme
s
s
a
g
e
.Ev
e
nta
c
k
nowl
e
dg
e
me
nti
nORL
message

UA

“
Una
bl
et
oa
c
c
e
ptor
de
r
/
s
e
r
v
i
c
e
”
. Ev
e
ntnot
i
f
i
c
a
t
i
oni
nOML me
s
s
a
g
e
.Ev
e
nta
c
k
nowl
e
dg
e
me
nti
nORL
message sent by the Order Filler in transaction LAB-1 or in ORL message sent by the Automation Manager intransaction LAB-4.

SC

“
St
a
t
usc
ha
ng
e
d”
.Ev
e
ntnotification in OML and OUL messages

CA

“
Ca
nc
e
lor
de
r
/s
e
r
v
i
c
er
e
que
s
t
”
.Ev
e
ntr
e
que
s
ti
nOMLme
s
s
a
g
es
e
ntbyt
heOr
de
rPl
a
c
e
ri
nLAB-1, or by theOrder Filler in LAB-4.

CR

“
Ca
nc
e
l
e
da
sr
e
que
s
t
e
d”
.Ev
e
nta
c
k
nowl
e
dg
e
me
nti
nORLme
s
s
a
ger
e
s
pond
i
ngt
oOML(
CA)

UC

“
Una
bl
et
oc
a
nc
e
l
”
.Ev
e
nta
c
k
no
wl
e
dge
me
nti
nORLme
s
s
a
g
er
e
s
pon
di
ngt
oOML(
CA)

Rev. 1.1–Final Text 08/07/2004

19

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
Value

Description of use

OC

“
Or
de
rs
e
r
v
i
c
ec
a
nc
e
l
e
d”
.Ev
e
ntnot
i
f
i
c
a
t
i
oni
nOMLme
s
s
a
g
es
e
ntbyt
heOr
de
rFi
l
l
e
ri
nt
r
a
ns
a
c
t
i
o
nsLAB-1and LAB-3.

SN

“
Se
ndor
de
r
/
s
e
r
v
i
c
enumbe
r
”
.Eve
ntr
e
que
s
tin OML message sent by the Order Filler in transaction LAB-2

NA

“
Numbe
ra
s
s
i
g
ne
d”
.Ev
e
nta
c
k
no
wl
e
dge
me
nti
nORLme
s
s
a
g
es
e
ntbyt
heOr
de
rPl
a
c
e
ri
nLAB-2, responding
to OML (SN)

RP

“
Or
de
r
/
s
e
r
v
i
c
er
e
pl
a
c
er
e
que
s
t
”
.Ev
e
ntr
e
que
s
ti
nOMLme
s
s
a
ges
e
ntbyt
he Order Placer in transaction LAB-1
or in OML message sent by the Order Filler in transaction LAB-4.

RQ

“
Re
pl
a
c
e
da
sr
e
que
s
t
e
d”
.Ev
e
nta
c
k
nowl
e
dg
e
me
nti
nORLme
s
s
a
ger
e
s
pond
i
ngt
oOML(
RQ)

UM

“
Una
bl
et
or
e
p
l
a
c
e
”
.Ev
e
nta
c
k
nowl
e
dge
me
nti
nORLme
s
s
a
g
er
e
s
ponding to OML (RQ)

RU

“
Re
pl
a
c
e
duns
ol
i
c
i
t
e
d”
.Ev
e
ntno
t
i
f
i
c
a
t
i
oni
nOMLmessage(
LAB-1) and OUL message (LAB-3) sent by theOrder Filler.

XO

“
Cha
ng
eor
de
r
/
s
e
r
v
i
c
er
e
que
s
t
”
.Us
e
dbyt
heOr
de
rPl
a
c
e
ri
nLAB-1

XR

“
Cha
ng
e
da
sr
e
que
s
t
e
d”
.Us
e
dbyt
heOr
de
rFiller in LAB-1 in response to XO

UX

“
Una
bl
et
oc
ha
ng
e
”Us
e
dbyt
heOr
de
rFi
l
l
e
ri
nLAB-1 in response to XO

610
ORC-2 Placer Order Number (EI), conditional.
Condition predicate: if the field is valued then its value shall match the value of the required
field OBR-2. Please refer to section 2.3.6.1 for the details of the data type.
ORC-3 Filler Order Number (EI), conditional.
Condition predicate: if the field is valued then its value shall match the value of the required
field OBR-3. Please refer to section 2.3.6.1 for the details of the data type.
ORC-4 Placer Group Number (EI), required if known to the sender.

620

The Placer Group Number represents an identification of a set of closely related orders, i.e.
the whole list of batteries ordered by the placer to the laboratory for one subject. Please referto section 2.3.6.1 for the details of the data type.
ORC-5 Order Status (ID), conditional.
Condition predicate: This field shall be valued in all OML messages sent by the Order Filler.
It represents the status of the order. This field shall not be valued in OML messages sent by
the Order Placer.
The allowed values for this field within IHE Laboratory Technical Framework are a subset of
HL7 table 0038 - Order Status:
Table 3.7-2 : HL7 table 0038 - Order Status: IHE subset for all transactions
Value

DescriptionA

Some, but not all, results available

CA

Order was canceledCM

Order is completed

IP

In process, unspecifiedSC

In process, scheduled

Comment

630
Note:

For the conditions of use of these values, please read section 3.12 “
Cor
r
el
at
i
onsofst
at
usbet
ween
ORC,OBRandOBX”.

Rev. 1.1–Final Text 08/07/2004

20

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

ORC-9 Date/Time of Transaction (TS), required640

HL7 Definition: This field contains the date and time of the event that initiated thecurrent transaction as reflected in ORC-1 Order Control Code. This field is not equivalent
to MSH-7 Date and Time of Message that reflects the date/time of the creation of thephysical message.
In OML messages "Status changed" sent by the Order Filler, this field contains thedate/time of the last status change of the order (ORC-5) or one of the ordered batteries(identified in the following OBR).
ORC-12 Ordering Provider (XCN), optional. If the field is valued then its value has tomatch the value of the required field OBR-16.
This field contains the person (physician) who prescribed this order. See the data model involume 1.
ORC-14 Callback Phone Number (XTN), optional. If the field is valued then its value has
to match the value of the required field OBR-17.

650

ORC-21 Ordering Facility Name (XON), required but may be empty.
This field contains the facility (care unit) placing this order. These three components shall
beva
l
ue
d:1s
t=Or
ga
ni
z
a
t
i
onna
me
.7t
h=I
de
nt
i
f
i
e
rTy
peCodewhi
t
ht
heva
l
u
e“
FI
”
,
whi
c
hme
a
ns“
Fa
l
i
l
i
t
yI
D”a
ss
t
a
t
e
dbyHL7tablen°0203.10t
h=Or
g
a
ni
z
a
t
i
onI
de
n
t
i
f
i
e
r
.
Example: Urology^^^^^^FI^^^UR01
ORC-27 Fillers Expectable Availability Date/Time (TS), conditional.
This field contains the date/time when the laboratory results are expected to be available.
Condition predicate: This field may be valued only in OML messages sent by the Order
Filler660

Rev. 1.1–Final Text 08/07/2004

21

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

3.8 TQ1 - Timing Quantity Segment
HL7 v2.5: chapter 4 (4.5.4)
Table 3.8-1: TQ1 - Timing Quantity Segment
SEQ

LEN

DT

Usage

Card.

TBL#

ITEM#

Element name

9

250

CWE

R

[1..1]

0485

01635

Priority

12

10

ID

C

[0..1]

0427

01638

Conjunction

This cycle of IHE Laboratory Technical Framework uses does not use TQ2 segment, and uses
only one occurrence of TQ1 segment, with a single field required in it: TQ1-9 Priority (CWE).
This field defines the priority of the order. The authorized values for this field are listed in
HL7 table 0485 - Priority codes:
Table 3.8-2: HL7 table 0485 - Priority codes
Value

Description
StatWith highest priority

A

ASAP

Fill after S orders

R

RoutineDefault

P

Preop

C

Callback

T

Timing critical

A request implying that it is critical to come as close as possible to the requested
time, e.g., for a trough anti-microbial level.

TS<integer>

Timing critical within <integer> seconds.

TM<integer>

Timing critical within <integer> minutes.

TH<integer>

Timing critical within <integer> hours.

TD<integer>

Timing critical within <integer> days.

TW<integer>

Timing critical within <integer> weeks.

TL<integer>
PRN

670

Comment

S

Timing critical within <integer> months.
As needed

All the other fields of TQ1 segment are left optional in this release of the framework.
Transactions LAB-1, LAB-2 and LAB-3 restrict the usage to the first 6 values: S, A, R,
P, C, T
TQ1-12 Conjunction (ID), conditional.
Condition predicate: this field shall only be used when the TQ1 segment occurs several times.
In this Framework, TQ1 segment may occur only once. Therefore, this field shall never befilled.

Rev. 1.1–Final Text 08/07/2004

22

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

3.9 SPM - Specimen Segment
HL7 v2.5: chapter 7 (7.4.3)
680

Table 3.9-1: SPM - Specimen Segment
SEQ

LEN

DT

Usage

Card.

2

80

EIP

C

[0..1]

3

80

EIP

RE

[0..*]

4

250

CWE

RE

[1..1]

8

250

CWE

C

[0..1]

9

250

CWE

C

[0..*]

11

250

CWE

RE

[0..*]

16

250

CWE

RE

[0..1]

17

26

DR

RE

18

26

TS

C

20

1

ID

C

[0..1]

21

250

CWE

C

[0..*]

26

4

NM

RE

[0..1]

TBL#

ITEM#

Element name01755

Specimen ID

01756

Specimen Parent IDs

01900

Specimen Type

01901

Specimen Source Site

0542

01760

Specimen Source Site Modifier

0369

01762

Specimen Role

0489

01903

Specimen Risk Code[0..1]

01765

Specimen Collection Date/Time[0..1]

00248

Specimen Received Date/Time

0136

01766

Specimen Availability

0490

01767

Specimen Reject Reason

01772

Number of Specimen Containers

0487

SPM-2 Specimen ID (EIP), conditional.
This field contains a unique identifier for the specimen, enterprise-wide.
Condition predicate: This field shall be populated in OML messages of transaction LAB1, in the context of the use case "Externally placed order with identified specimens"
defined in volume 1. This field is required in OML messages of the LAB-2 transactions.
It may also be used in transactions LAB-3. This field is required if known (RE) intransactions LAB-4 and LAB-5. Please refer to section 2.3.6.1 for the details of the data
type.
690

SPM-3 Specimen Parent ID (EIP), required if available.
This field contains the identifier for the parent specimen, from which the specimen
described by the segment instance has been extracted. Please refer to section 2.3.6.1 forthe details of the data type.
This version of IHE Laboratory Technical Framework does not admit pooling ofspecimens; therefore the maximum cardinality for the parent specimen is 1. See the data
model in Volume 1 of this document.
SPM-4 Specimen Type (CWE), required if available.

700

The authorized values for this field are those of HL7 table 0487 - Specimen type. See
HL7v2.
5c
ha
pt
e
r7(
7.
18.
4)
.HL7doe
s
n’
ts
ugge
s
tva
l
ue
sf
ort
a
bl
e0487.Thef
ol
l
owi
ng
table, which is a subset of HL7 table 0070, provides some values as an example.
Value
ABS

Description
Abscess

AMN

Amniotic fluid

ASP

AspirateRev. 1.1–Final Text 08/07/2004

23

Comment

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
Value
BIFL

Description
Bile fluid

BLDA

Blood arterial

BBL

Blood bag

BLDC

Blood capillary

BPU

Blood product unit

BLDV

Blood venous

BON

Bone

BRO

Bronchial

BRN

Burn

CALC

Calculus (=Stone)

CDM

Cardiac muscle

CNL

CannulaCTP

Catheter tip

CSF

Cerebral spinal fluid

CVM

Cervical mucus

CVX

CervixCOL

Colostrum

BLDCO

Cord blood

CNJT

Conjunctiva

CUR

Curettage

CYST

Cyst

DIAF

Dialysis fluid

DOSE

Dose med or substance

DRN

Drain

DUFL

Duodenal fluid

EAR

Ear

EARW

Ear wax (cerumen)

ELTElectrode

ENDC

Endocardium

ENDM

Endometrium

EYE

Eye

EXG

Exhaled gas (=breath)

FLT

FilterFIST

FistulaFLU

Body fluid, unsp

GAS

Gas

GAST

Gastric fluid/contents

GEN

GenitalGENC

Genital cervix

GENL

Genital lochia

Rev. 1.1–Final Text 08/07/2004

24

Comment

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
Value
GENV

Description
Genital vaginal

HAR

Hair

IHG

Inhaled Gas

ITIntubation tube

ISLT

IsolateLAM

Lamella

LN

Line

LNA

Line arterial

LNVLine venous

LIQ

Liquid NOSMARMarrow

MEC

Meconium

MBLD

Menstrual blood

MLK

Milk

MILK

Breast milk

NAIL

Nail

NOS

Nose (nasal passage)

ORH

Other

PAFL

Pancreatic fluid

PRT

Peritoneal fluid /ascites

PLC

Placenta

PLAS

PlasmaPLB

Plasma bag

PLR

Pleural fluid (thoracentesis fld)

PPP

Platelet poor plasma

PRP

Platelet rich plasma

PUS

Pus

RT

Route of medicine

SAL

SalivaSMN

Seminal fluid

SER

Serum

SKN

Skin

SKM

Skeletal muscle

SPRM

Spermatozoa

SPT

SputumSPTC

Sputum - coughed

SPTT

Sputum - tracheal aspirate

STL

Stool = Fecal

SWT

Sweat

SNV

Synovial fluid (Joint fluid)Rev. 1.1–Final Text 08/07/2004

25

Comment

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
Value
TEAR

Description
Tears

THRT

Throat

TISS

Tissue

TISG

Tissue gall bladder

TLGI

Tissue large intestine

TLNG

Tissue lung

TISPL

Tissue placenta

TSMI

Tissue small intestine

TISU

Tissue ulcer

TUB

Tube NOS

ULC

Ulcer

UMB

Umbilical blood

UMED

Unknown medicine

URTH

Urethra

UR

Urine

URC

Urine clean catch

URT

Urine catheter

URNS

Urine sediment

USUB

Unknown substance

VITF

Vitreous Fluid

VOM

Vomitus

BLD

Whole blood

BDY

Whole body

WAT

Water

WICK

Wick

WND

Wound

WNDA

Wound abscess

WNDE

Wound exudate

WNDD

Wound drainage

Comment

SPM-8 Specimen Source Site (CWE), conditional.
Condition predicate: This field should be populated by the placer in microbiology, when the
s
pe
c
i
me
ns
our
c
es
i
t
ei
sknown.Exa
mpl
e
:“
EAR”
.
SPM-9 Specimen Source Site Modifier (CWE), conditional.
Condition predicate: This field should be populated by the placer in microbiology, when thespecimen source sitemodi
fieri
sknown.Exa
mple:“
LEFT”whe
nt
hes
pe
c
i
me
nha
sbe
e
n
collected from the left ear.
710

SPM-11 Specimen Role (CWE), required if known by the sender.
The allowed values are in HL7 user defined table 0369.

Rev. 1.1–Final Text 08/07/2004

26

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
User-defined Table 0369 - Specimen Role
Value
B
C
E
F
G

L

O
P
Q
R
V

Description
Blind Sample
Calibrator, used for initial setting of calibration
Electronic QC, used with manufactured reference
providing signals that simulate QC results
Specimen used for testing proficiency of theorganization performing the testing (Filler)
Group (where a specimen consists of multiple
individual elements that are not individually
identified)Pool (aliquots of individual specimens combined toform a single specimen representing all of thecomponents.)
Specimen used for testing Operator Proficiency
Patient
Control specimen
Replicate
Verifying Calibrator, used for periodic calibration
checksComment

SPM-16 Specimen Risk Code (CWE), required if available.
This field contains any known or suspected specimen hazards. The authorized values forthis field are those of HL7 table 0489 - Risk Codes. See HL7 v2.5 chapter 7 (7.4.3.16).

720

Condition predicate:This field shall be populated if known in OML messages sentby the Order Placer, within transaction LAB-1, and OML messages sent by the Order
Filler within transactions LAB-2 and LAB-4. The allowed values are given by HL7 userdefined table 0489:
User-defined Table 0489 –Risk Codes
Code
BIO

Description
BiologicalComment/Usage Note/Definition
The dangers associated with normal biological materials. I.e. potential
risk of unknown infections. Routine biological materials from living
subjects.
Material is corrosive and may cause severe injury to skin, mucous
membranes and eyes. Avoid any unprotected contact.
The entity is at risk for escaping from containment or control.

COR

Corrosive

ESC

Escape Risk

AGG

Aggressive

IFL

MaterialDangerInflammable

EXP

Explosive

INF

MaterialDangerInfectious

BHZ

Biohazard

INJ
POI

Injury Hazard
PoisonRAD

Radioactive

A danger that can be associated with certain living subjects, including
humans.
Material is highly inflammable and in certain mixtures (with air) may
lead to explosions. Keep away from fire, sparks and excessive heat.
Material is an explosive mixture. Keep away from fire, sparks, andheat.
Material known to be infectious with human pathogenic
microorganisms. Those who handle this material must takeprecautions for their protection.
Material contains microorganisms that are an environmental hazard.
Must be handled with special care.
Material is solid and sharp (e.g., cannulas.) Dispose in hard container.
Material is poisonous to humans and/or animals. Special care must be
taken to avoid incorporation, even of small amounts.
Material is a source for ionizing radiation and must be handled withspecial care to avoid injury of those who handle it and to avoid
environmental hazards.

SPM-17 Specimen Collection Date/Time (DR), required if available.

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Definition: The date and time when the specimen was acquired from the source. The useof the Date Range data type allows for description of specimens collected over a period oftime, for example, 24-hour urine collection. For specimens collected at a point in time,
only the first component (start date/time) will be populated
SPM-18 Specimen Received Date/Time (TS), conditional.
The time that the specimen is received at the laboratory.
730

Condition predicate: This field shall be populated in OML messages sent by the Order
Filler, within transactions LAB-1 (all use cases), LAB-2 and LAB-3, if the specimen has
been received by the laboratory. In other words this field is RE for the order filler actor inboth transactions LAB-1, LAB-2 and LAB-3.
SPM-20 Specimen Availability (ID), conditional.
This describes whether the specimen, as it exists, is currently available to use in ananalysis. The two authorized values are "Y" (yes) or "N" (no).

740

Condition predicate: This field shall be populated in OML messages sent by the Order
Filler, within transactions LAB-1 (all use cases) and LAB-2. The value 'N' indicates either
that the laboratory hasn't received the specimen yet, or that it has rejected the received
specimen. In other words this field is RE for the order filler actor. The value of this field
can be implicitly derived from ORC-5 (e.g. ORC-5=‘
I
P’i
mpl
i
c
i
t
l
yme
a
nst
ha
tt
he
specimen has arrived, otherwise the test could not be in progress).
This field is pointless in messages sent by the Order Placer.
SPM-21 Specimen Reject Reason (CWE), conditional.
This describes one or more reasons the specimen is rejected for the ordered batteries
Condition predicate: This field shall be populated in OML messages sent by the Order
Filler in transaction LAB-1, whenever the laboratory rejects a specimen.
Refer to HL7 Table 0490 - Specimen Reject Reason for valid values:
Table 3.9-2 : HL7 Table 0490 - Specimen Reject Reason
Value

750

Description

EX

ExpiredQS

Quantity not sufficientRB

broken container

RC

ClottingRDmissing collection dateR

missing patient ID numberRE

missing patient name

RH

Hemolysis

RI

Identification problem

RL

Improper labelingRMlabeling

RN

contaminationRP

missing phlebotomist ID

RR

improper storage

RS

name misspelling

Comment

SPM-26 Number of Specimen Containers (NM), required if available.

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HL7 Definition: This field identifies the number of containers for a given specimen. For
sample receipt verification purposes; may be different from the total number of specimensthat accompany the order.

3.10 SAC Container Detail Segment
HL7 v2.5: chapter 13
The IHE Laboratory Technical Framework defines the usage of 2 SAC fields; it allows allother fields to be optionally used.
Table 3.10-1 : SAC Segment
SEQ

LEN

DT

Usage

Card.

3

80

EI

R

[1..1]

TBL#

ITEM#
01331

Container Identifier

Element name

4

80

EI

C

[0..1]

01332

Primary (parent) Container Identifier

6

300

SPS

X

[0..0]

00249

Specimen Source

760
Condition for the use of the SAC segment in OML^O21, ORL^O22, OML^O33,
ORL^O34: The SAC segment should be used in those message structures within transactions
LAB-1, LAB-2, LAB-4 and LAB-5, only if the number of containers differs from the numberof specimens (e.g. a specimen is split between several containers) or if the container identifierdiffers from the specimen identifier. Otherwise, when there is one container for one sample,
and one identifier for both specimen and container, then, the SPM segment is sufficient: The
SPM-2 Specimen ID provides the specimen/container identifier. The SPM-3 Specimen Parent
Ids provides the identification of the primary specimen in case of an aliquot.
770

SAC-3 –Container Identifier (EI), required.
SAC-3 field identifies the container. This field is the container's unique identifierassigned by the corresponding equipment. A container may contain the primary (original)
specimen or an aliquot (secondary sample) of that specimen. For primary sample thisfield contains Primary Container ID; for bar-coded aliquot samples this field contains
Aliquot Container ID.
SAC-4 –Primary (parent) Container Identifier (EI), conditional.

780

Condition predicate: This field is used only in transactions LAB-4 and LAB-5 when dealing
with an aliquoted specimen. In that case, SAC-3 and SAC-4 are used simultaneously as
described below:
If SAC-4 field is filled in, it identifies the primary container from which this specimen
came. For primary samples this field is empty; for aliquot samples this field should
contain the identifier of primary container.

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3.11 OBX - Observation/Result Segment
HL7 v2.5: chapter 7 (7.4.2)
Table 3.11-1 : OBX Segment
SEQ

LEN

DT

Usage

Card.

1

4

SI

R

[1..1]

2

2

ID

C

[0..1]

3

250

CE

R

[1..1]

4

20

ST

C

5

99999

Varies

6

250

CE

7

60

8
9

TBL#

ITEM#

Element name00569

Set ID –OBX

00570

Value Type

00571

Observation Identifier[0..1]

00572

Observation Sub-ID

C[0..1]

00573

Observation Value

C[0..1]

00574

Units

ST

RE

[0..1]

00575

References Range

5

IS

RE

[0..1]

00576

Abnormal Flags

5

NM

X

[0..0]

00577

Probability

10

2

ID

X

[0..0]

0080

00578

Nature of Abnormal Test

11

1

ID

R

[1..1]

0085

00579

Observation Result Status

12

26

TS

X

[0..0]

00580

Effective Date of Reference Range

13

20

ST

C

[0..1]

00581

User Defined Access Checks

14

26

TS

RE

[0..1]

00582

Date/Time of the Observation

15

250

CE

RE

[0..1]

00583

Producer's ID

16

250

XCN

RE

[0..1]

00584

Responsible Observer

17

250

CE

C

[0..1]

00936

Observation Method

18

22

EI

X

[0..0]

01479

Equipment Instance Identifier

19

26

TS

X

[0..0]

01480

Date/Time of the Analysis

0125

0078

OBX-1 Set ID - OBX (SI), required.
790

This field contains the sequence number of the OBX.
OBX-2 Value Type (ID), conditional.
Condition predicate: This field shall be valued if OBX-5 (Observation Value) is populated.
The Value Type field should be filled according to HL7 Version 2.5 standard (table 0125).
For example, if the result is ">300" the Value Type "SN" (Structured Numeric) SHALL beused instead of the "ST" (String) value type that was used in previous versions of HL7. See
the details and the examples in the HL7 V2.5 (7.4.2). For an observation that consists of atime measurement (e.g. bleeding time) the TM Value Type is preferred to NM but this is notmade mandatory.

800
OBX-3 Observation Identifier (CE), required
The usage of LOINC(r) test codes for the identification of tests is strongly recommended.
Details of this free vocabulary can be found at http://www.loinc.org .
The first and third sub-f
i
e
l
ds“
I
de
nt
i
f
i
e
r
”
,a
nd“
Na
meofCodi
ngSy
s
t
e
m”a
r
er
e
qui
r
e
di
na
l
l
t
r
a
ns
a
c
t
i
ons
.Theva
l
ueoft
he“
Na
meofCodi
ngSy
s
t
e
m”i
nt
hec
a
s
eofLOI
NCi
s“
LN”
.

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In transaction LAB-3 the second sub-f
i
e
l
d“
Te
xt
”i
sma
nda
t
or
y
,whi
c
ha
l
l
owst
heOr
de
r
Result Tracker to manage the results without the help of Test Master File.
The last three sub-fields are optional in all transactions.
810

OBX-4 Observation Sub-ID (ST), conditional.
Condition predicate: This field shall be used to distinguish between multiple OBX segmentswith the same observation ID organized under one OBR.
See HL7 V2.5 (7.4.2) for details and examples.
OBX-5 Observation Value (varies), conditional.
Condition predicate: This field is required unless the Observation Result Status field (OBX11) is valued either with "D", or "I" or "X". The Observation Value field shall be valued
accordingly to the definition made in Chapter 7 of HL7 2.5 version.
OBX-6 Units (CE), conditional.

820

This field in required if the Value Type field (OBX-2) is valued either with "NM", or "SN". Ifvalued, this field should identify SI or SI-derived units only.
OBX-7 References Range (ST), required if available.
This field should be valued as described in HL7 V2.5 for all observations for which it isrelevant. The References range that figures in this field is supposed to be related to age andsex of the patient or to other parameters such as number of weeks of pregnancy whenapplicable, which makes the OBX-10 field (nature of abnormal test) unnecessary.
OBX-8 Abnormal Flags (IS), required if available.

830

This field is required when applicable. This field is not repeatable in the IHE Laboratory
Framework. Among the possible values listed for this field in HL7 table 0078, the actors of
IHE Laboratory Technical Framework should support the following values:
Table 3.11-2 : HL7 table 0078
Value

Description

L

Below low normal

H

Above high normal

LL

Below lower panic limits

HH

Above upper panic limits

N

Normal (applies to non-numeric results)A

Abnormal (applies to non-numeric results)

AA

Very abnormal (applies to non-numeric units, analogous to panic limits for numeric units)

Null

No range defined, or normal ranges don't apply

S

Susceptible. Indicates for microbiology susceptibilities only.

R

Resistant. Indicates for microbiology susceptibilities only.

I

Intermediate. Indicates for microbiology susceptibilities only.

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31

Comment

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
As described in the above table, the S, R, or I values shall be used to indicate the interpreted
result of susceptibilities in microbiology, in case the value field (OBX-5) contains a numericvalue that represents the MIC (Minimum Inhibitive Concentration). In case the order filler
only reports the interpreted result for susceptibilities, the S, R, or I value could be filled in thevalue field (OBX-5) with a Value Type (OBX-2) set to "ST".
840

OBX-11 Observation Result Status (ID), required.
This field should be filled according to HL7 Table 0085 described in Chapter 7 of HL7. In
this version of the Laboratory Technical Version, the possible values for this field are asubset of this table:
Table 3.11-3 : HL7 Table 0085
Value

Description

Comment

O

Order detail description only (no result)This can be used in LAB-3 to provide the Order Result
Tracker with the list of individual tests that will be performed

I

Specimen in lab; results pending

This can be used in LAB-3 to provide the Order Result
Tracker with the list of individual tests that are being
performed

D

Deletes the OBX record

This status should be used when the sender (Order Filler in
LAB-3 and LAB-4, Automation Manager in LAB-5) wants tocancel a false result transmitted in a former message, in thesituation where the right result is still pending. The result
should NEVER be shown to clinical users.

R

Results entered –not verified

In LAB-5: not technically validated.
In LAB-3: not clinically validated.

P

Preliminary results

In LAB-5: result technically validated but can still change
In LAB-3: result clinically validated but can still change

F

Final results; Can only be changed with acorrected result.

Can only be changed with a corrected result.
In LAB-1 and LAB-3, a final result is clinically validated.
In LAB-5, a final result is technically validated.

C

Record coming over is a correction andthus replaces a final result

This status may be used only after an ‘F’ora‘
C’s
t
a
t
us
.

X

Results cannot be obtained for thisobservation

Tests that have this status have to be shown to the user.

Note:

850

For the conditions of use of these values, please read section 3.12 “Correlations of status between
ORC,OBRandOBX”.

OBX-12 Effective Date of Reference Range (TS)Since the Reference range given by the order filler is the one that applies to the Observation
result taking into account other parameters such as patient age or sex; there is no need to
manage the present field. The Order Result Tracker should store the observation result and its
associated reference range. In case the Order Result Tracker offers the capability to compare
results of the same observation over different requests, it should then associate each resultwith its associated reference range.
OBX-13 User Defined Access Checks (ST), conditional.

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860

Condition predicate: In transaction LAB-3, the Order Filler should value this field with a "P"
when it wants to inform the Order Result Tracker of restricted access on some results toprivileged users.
OBX-14 Date/Time of the Observation (TS), required if available.
This field should be valued when the OBX-5 field (Value field) is also valued. In very
exceptional case this information may be unknown by the Order Filler (case the test istransmitted in a reference lab and observation date and time is not returned together with theresult), this field can be null and the Order Result Tracker should not generate an error.
OBX-15 Producer's ID (CE), required if available.

870

This field is required in case the observation was not produced by the sending organization.
OBX-16 Responsible Observer (XCN), required if available.
This field is required when the observation result status (OBX-11) is valued with "D" or "R"or "P" or "F" or "C" or "X" and the Producer's ID field is not valued. It should contain theidentity of the observer that causes the change of the observation result status. Only the firstcomponent (ID number) of this field is necessary, provided that it is possible to retrieve thefull identity of responsible person in the Order Filler system with only this ID number.
OBX-17 Observation Method (CE), conditional.

880

Condition predicate: This field is required when the value of the result may be dependant of
the Observation Method and the Observation Identifier does not permit to identify the
Method. With some Observation Identifiers such as LOINC(r) Codes, the identifier also
identifies the Method, in which case this field does not need to be valued.
OBX-18 Equipment Instance Identifier (EI), not supported.
Although this information should be available at the Order Filler level, this field should not
be used in this first version of the Laboratory Technical Framework.
OBX-19 Date/Time of the Analysis (TS), not supported.
Since the OBX-18 field shall not be used this OBX-19 field is meaningless.

890

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3.12 Correlations of status between ORC, OBR, OBX
3.12.1 Semantics of the main status code associations
In HL7 version 2.5 a change in the status of an observation is identified by a combination of
the Trigger Event field contained in segment MSH, the ORC-5 (Filler Order status) field, theOBR-25 (Order Result Status) field and the OBX.11 (Observation Result Status) field. OBX11 contains the status of an individual test, OBR-25 the status of the entire request.
Summary of the 3 relevant reference tables:
Order
Table 0038
(ORC-5)

RequestTable 0123
(OBR-25)

ResultTable 0085
(OBX-11)

O

O

SC

S

IP

I

A

R

A

Description (combined from 3 tables)

Order received; specimen not yet received. Order detail description
only (OBX contains no result).
This value should only be used in ORL event acknowledgment
messages. It should not be used in OML messages.
No results available; procedure scheduled, but not done.
The specimen may not have arrived at the laboratory. No OBX ispresent

I

In process; The specimen is available in the laboratory; results are
pending; the procedure is incomplete

D

Deletes the OBX record

R(Some) results entered -- not yet verified

P

P(Some) preliminary verified results: ( technically validated in LAB-5,
clinically validated in LAB-3). The final results are not yet obtained

CM

F

F

Final results; results stored and verified : ( technically validated in
LAB-5, clinically validated in LAB-3). Can only be changed with acorrected result.

(CM)

C

C

Record coming over is a correction and thus replaces a final result

CA

X

X

(OBX) Results cannot be obtained for this observation. (ORC/OBR)
No results available; Order canceled.

Notes:
900

The status codes used in ORC-5a
r
el
e
s
s‘
a
t
omi
c
’t
ha
nt
hos
eus
e
di
nOBR-25/OBX-11. If
t
he
r
ei
snodi
r
e
c
t‘
s
e
ma
nt
i
cma
t
c
h’t
heORC-5 column lists the closest equivalent between
braces.
The table shown above contains a description of the semantics of the code values used bythese fields. Please note that this table does not identify all possible relationships of thevarious status fields. The relationship between the various status fields are described below.

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3.12.2 Status transition diagrams
3.12.2.1 ORC-5: Order status910

The status fields of an order and the associated result express the status of the order and result
as they are processed and finalized. The transition of the coded values used in the status fields
is shown below:
SC: In process, scheduled,specimen may not be available
yet
IP: In process, specimen available
in laboratory
A: Some but not all results
available
CM: Order is completed
CA: Order canceled (at any stageof the process)

IP
SC
A

CM

CA

Figure 3.12.2.1-1: The ORC-5 status transition diagram

The status diagram in figure 3.12.2.1-1 above shows that, during normal processing, theinitial status code in ORC-5 will be SC, IP, A or CM. If the status code equals SC, the next
status code could be IP, A, CM or SC. If the status code equals IP, the next status code could
be A, CM or IP. The special status codes CA (order was canceled) may occur at any stage ofprocessing.
920
3.12.2.2 OBR-25: Order Result status
I

R
C

O

S

P

F

X

O: Order received. Specimen not yet received
S: Scheduled, specimen may not be available
yet
I: Specimen available, results pending
R: Some results available, not verified, i.e.
not technically (LAB-5) or clinically (LAB-3)
validated
P: Preliminary (partial) results verified, i.e.
technically (LAB-5) or clinically (LAB-3)
validated
F: Final results verified, i.e. technically(LAB-5) or clinically (LAB-3) validated
C: Correction after final results. Results still
final and verified.
X: Order canceled (at any stage of theprocess)

Figure 3.12.2.2-1: The OBR-25 status transition diagram930

The status diagram in figure 3.12.2.2-1 above shows that, during normal processing, theinitial status code in OBR-25 will be O, F, or one of the four codes shown in the center block.
If the status code equals S, the next status code could be either I, R, P, F or S. If the status
code equals P, the next status code could be either F or P. If the status code equals F, the nextRev. 1.1–Final Text 08/07/2004

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status could be either F or C. The special status code X (order canceled) may occur at any
stage of processing.

3.12.2.3 OBX-11: Obsevation Result Status

R
C

I
P

O

X

940

F

D

O: Order detail description only. No result
I: Specimen in lab, results pending
R: Result entered, not verified, i.e. nottechnically (LAB-5) or clinically (LAB-3)
validated
P: Preliminary (partial) result verified, i.e.
technically (LAB-5) or clinically (LAB-3)
validated
F: Final result verified, i.e. technically(LAB-5) or clinically (LAB-3) validated
C: Correction after final result. Result still
final and verified.
X: Result cannot be obtained for thisobservation
D: Deletes the OBX record

Figure 3.12.2.3-1: The OBX-11 status transition diagram

The status diagram in figure 3.12.2.3-1 above shows that, during normal processing, theinitial status code in OBX-11 will be O, F, or one of the three codes shown in the center block.
If the status code equals I, the next status code could be either I, R, P or F. If the status codeequals P, the next status code could be either F or P.
The special status codes X (Result cannot be obtained for this observation) and D may occur
at any stage of processing.

3.12.3 Relationship between the 3 status fields
The relationship between the 3 status fields is stated by the following rules:
950

1. The status as contained in the OBR-25f
i
e
l
dc
a
nnotbe“
hi
g
he
r
/
mor
ef
i
na
l
i
z
e
d”t
ha
n
t
he“
l
owe
s
t
”s
t
a
t
usofa
nyoft
her
e
l
a
t
e
di
ndi
vi
dua
lt
e
s
t
s(
a
sc
ont
a
i
ne
di
nOBX-11). For
example: OBR-25c
a
nonl
ybe‘
F’(
Fi
na
l
)whe
na
l
lr
e
l
a
t
e
dOBX-11f
i
e
l
dsc
ont
a
i
n‘
F’
.
2. Thes
t
a
t
usoft
heor
de
ra
sde
f
i
ne
dbyt
heOr
de
rFul
f
i
l
l
e
rc
a
nnotbe“
hi
g
he
r
/
mor
e
f
i
na
l
i
z
e
d”t
ha
nt
hes
t
a
t
usoft
her
e
l
a
t
e
dr
e
que
s
t(
a
sc
ont
a
i
ne
di
n OBR-25). For
example: ORC-5 can only be‘
CM’(
Compl
e
t
e
)whe
nt
her
e
l
a
t
e
d OBR-25 field
c
ont
a
i
ns‘
F’(
Fi
na
l
)or‘
C’(
Cor
r
e
c
t
e
d)
.
3. Fort
hepur
pos
e
sofde
t
e
r
mi
ni
ngwhi
c
hs
t
a
t
usi
s“
hi
g
he
r
/
mor
ef
i
na
l
i
z
e
d”
,a
nyOBX-11
status code value equal to X or D, and any OBR-25 status code value equal to X
should be compared as if the value was F.

960

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4 Transaction LAB-1 : Placer Order Management
4.1 Scope
Transaction LAB-1 is used by all of the three general use cases described in Volume 1.
This transaction is used by the Order Placer to place a new order to the Order Filler. An orderis prescribed by a physician and/or ordered by a care unit, and is performed by a clinicallaboratory. The order contains a list of batteries or test to be fulfilled, using biological
specimens collected from the subject. A battery contains one or more tests, each of which
may produce one or more observations.
970

In some organizations the care unit provides the specimens and identifies them. In others, thelaboratory collects and identifies them. In both cases, the laboratory is responsible forobtaining and managing valid specimens for the ordered batteries, in conformity with goodlaboratory practices. It is able to refuse the execution of the order or a part of it, if a specimen
is non conforming, or missing.
Both Order Placer and Order Filler may update or cancel a former order. Update consists in
replacing or removing batteries from the original list.
Adding new batteries by the Order Filler is out of scope of LAB-1: This task is achieved bytransaction LAB-2.

980

The main goal of the Placer Order Management Transaction is to allow consistent
management of the content and status of the order between the Order Placer and Order Filler
actors.

4.2 Use Case Roles

Order Placer

Order Filler

Placer Order Mgt

Actor :Order Placer
Roles : Places orders. Updates orders. Cancels orders. Nullifies orders. Receives acceptanceor rejection from the Order Filler. Receives order related changes from the Order Filler.
Actor :Order Filler
990

Roles : Receives orders. Checks the specimens required, and notifies the Order Placer of
acceptance or refusal. Receives order related changes from the Order Placer. Notifies content
updates (removed batteries/tests) to the Order Placer. Notifies the progression (scheduled,started, cancelled, completed) to the Order Placer.

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4.3 Referenced standards

1000

HL7 version 2.5:

Chapter 2: "Control" --> generic segments and data types
Chapter 3: "ADT" --> PID and PV1 segmentsChapter 4: "Order Entry" --> OML and ORL messages
Chapter 7: "Observation Reporting" --> SPM segment
Chapter 13: "Clinical Laboratory Automation" --> SAC segment

4.4 Interaction diagrams
Trigger events: In all interactions below, the initiator chooses the best OML message
structure appropriate to its orders. The responder SHALL respond with the related ORL
message structure:
OML^O21  ORL^O22
OML^O33  ORL^O34
OML^O35  ORL^O36
An OML message shall be responded to with exactly 1 ORL message.
1010
Please note that the filler order number is required in the ORL messages. ORL messages
SHALL be created by the Order Filler application, and not by a message broker or acommunication system. The message broker (an intermediary between the Order Placer and
t
heOr
de
rFi
l
l
e
r
)ha
snoknowledgeoft
het
e
s
t
sbe
i
ngr
e
que
s
t
e
da
ndc
a
n’
ta
c
c
e
pt
/
r
e
j
e
c
tt
he
s
e
test on behalf of the Order Filler.

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4.4.1 Normal process of a placer order
The figure below shows the flow of messages in the normal process of a placer order, fromplacing of the order by the Order Placer, to the "order completed" event notified by the Order
Filler.
Order Placer

Order Filler

Placement of
a new order

OML New Order: ORC-1 = NW

ORL Order accepted: ORC-1 = OK
Unable to accept: ORC-1 = UA

Placer order checked with therelated specimens. Some battery
may be replaced or canceled

OML Battery replaced: ORC-1 = RU
Battery canceled: ORC-1 = OC
ORL acknowledgement: ORC-1 = OK
Status of the order changed
OML Status changed: ORC-1 = SC
ORL acknowledgement: ORC-1 = OK

Replacementof an order

OML Replace Order: ORC-1 = RP

ORL Replaced as requested: ORC-1 = RQ
Unable to replace: ORC-1 = UM

1020
Figure 4.4-1: Normal process of a placer order
Note: the laboratory may accept an order, with some batteries waiting for a new specimen.

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4.4.2 Cancellation of an order by the Order Placer

Order Placer

Order Filler

Placer ordercancelled
OML Cancel order request: ORC-1 = CA
ORL acknowledgement
Cancelled as requested: ORC-1 = CR
Unable to cancel: ORC-1 = UC

For each battery, the cancel
request is accepted or
refused (if the processing has
already started)

Figure 4.4-2: Cancellation of an order by the Order Placer

1030

The Order Filler accepts the cancellation only if the processing has not started yet,particularly if no work order has been sent to the Automation Manager (through transaction
LAB-4).

4.4.3 Cancellation of an order initiated by the Order Filler

Order Placer

Order Filler

OML Order cancelled: ORC-1 = COCancellation of
the order
initiated by thelaboratory

ORL acknowledgement ORC-1 = OK

Figure 4.4-3: Cancellation by Order Filler

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4.5 Messages static definitions
4.5.1 Available HL7 2.5 structures for OML message
1040

1050

HL7 v2.5 chapter 4, offers three different message structures for the OML message type : OML^O21^OML_O21: laboratory order message. This is a battery-centric
structure: It contains a list of ordered batteries, a list of specimens underneath eachbattery, and a list of containers underneath each specimen. This structure implies
duplication of specimen/container information whenever two batteries use the same
specimen. It is more appropriate for ordering batteries that need several specimens(e.g. creatinine clearance, glucose tolerance test).
 OML^O33^OML_O33: Laboratory order for multiple orders related to a single
specimen. This is a specimen-centric structure providing for each specimen a list ofcontainers and a list of batteries (ORC/OBR segment groups) using this specimen.
The batteries are not related to the containers.
 OML^O35^OML_O35: Laboratory order for multiple orders related to a single
container of a specimen. This message structure provides for each specimen a list ofcontainers, and for each container the list of batteries that are to be performed on that
container. This structure is more appropriate when the ordered batteries are sorted bycontainer.
4.5.2 Restrictions on OML message for transaction LAB-1

1060

1070

This cycle of Laboratory Technical Framework supports the three message structures defined
above, and makes the following restrictions for transaction LAB-1:LAB-1 carries all clinical observations provided by the Care Unit, such as allergy,
therapy, diagnosis, temperature, urine volume, blood pressure, within observation
segments (OBX) that accompany the order. This choice has been made to simplify thebuilding and parsing of the messages. All these specific patient observations are sentin the OML message, in OBX segments.
LAB-1 restrains timing/quantity to one execution per order. This choice has also been
made by "HL7 UK". The main reason for this choice is:
The only operation that would have needed the iteration features provided by thesegment TQ1 is the specimen collection. In this Laboratory Integration Profile thisoperation is not triggered by any message: It is an internal operation performed within
the Order Placer actor or the Order Filler actor, depending on the organization. All
orders sent to laboratories require one single execution, even the studies based on atemporal series of specimens. For example a serum glucose tolerance study is anatomic order to be performed once, taking into account all the specimens to be tested.

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4.5.3 OML^O21 static definition
Table 4.5-1: OML^O21 static definition for transaction LAB-1
Usage

Card.

HL7 chapter

MSH

Segment

Message Header

R[1..1]

2[--- PATIENT begin

O[0..1]

PID

Patient IdentificationR[1..1]

3[ PV1 ]

Patient VisitRE[0..1]

3]--- PATIENT end{--- ORDER beginR[1..*]

ORC

Common Order (for one battery)R[1..1]

4[{TQ1}]

Timing Quantity

RE[0..1]

4[--- OBSERVATION REQUEST beginR[1..1]

OBR

Observation Request

R[1..1]

4{[NTE]}

Notes and CommentsO[0..*]

2[{--- OBSERVATION begin

O[0..*]

OBX

Observation ResultR[1..1]

7[{NTE}]

Comment of the result

C[0..*]

2}]--- OBSERVATION end[{--- SPECIMEN begin

O[0..*]

SPM

SpecimenR[1..1]

7[{SAC}]

ContainerC[2..*]

13}]--- SPECIMEN end
O[0..*]

RE[0..1]--- PRIOR_RESULT begin[{–previous result

PV1

Patient Visit{--- ORDER_PRIOR beginR[1..*][ORC]

Common OrderO[0..1]

4

OBR

Order DetailR[1..1]

4{[NTE]}

Notes and CommentsO[0..*]

2{--- OBSERVATION_PRIOR beginR[1..*]

OBX

Observation/ResultR[1..1]

7{[NTE]}

Notes and Comments- previous result--- OBSERVATION_PRIOR end--- ORDER_PRIOR end

O[0..*]

2}}]}

Meaning- previous result- previous result- previous result- previous result

3--- PRIOR_RESULT end]--- OBSERVATION REQUEST end}--- ORDER end

Field MSH-9 - Message Type (MSG) shall have its three components respectively valued to
“
OML”
,“
O21”a
nd“
OML_O21”.
The triplet (ORC, TQ1, OBR) represents the order (i.e. an ordered battery/test). This triplet isrepeated as many times as the number of batteries contained in the order group.
1080

The OBSERVATION repeatable segment group carries the observations provided by the
or
de
r
e
r(
pa
t
i
e
ntt
e
mpe
r
a
t
ur
e
,bl
oodpr
e
s
s
ur
e
,we
i
ght
,…)
,wi
t
he
ve
nt
ua
lc
omme
nt
s(
NTE)
.

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The OBSERVATION PRIOR provides the prior results obtained for the same patient.
Segment PID is not provided in this segment group because it is the same patient, and thelaboratory is not concerned by the fact that this patient might have had a different
identification when the prior results were produced.
Condition predicate for the SAC segment: See the common definition of the SAC segment insection 3.10.
Condition predicate for the NTE segment below OBX (Comment of the result): Informationthat can be coded in OBX segments or OBR segments shall not be sent in a NTE segment.
1090

4.5.4 ORL^O22 static definition
Table 4.5-2 : ORL^O22 Message
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message header

R[1..1]

2

MSA

Message AcknowledgementR[1..1]

2[{ERR}]

Error

C[0..*]

2[PID]

Patient IdentificationO[0..1]

3{--- ORDER beginR[1..*]

ORC

Common OrderR[1..*]

4[{TQ1}]

Timing/Quantity

RE[0..1]

4[--- OBSERVATION REQUEST beginR[1..1]

OBR

Observation Request

R[1..1][{--- SPECIMEN begin

O[0..1]

SPM

SpecimenR[1..1]

7[{SAC}]

Specimen Container Details

O[0..*]

7

}]
]
}

4

--- SPECIMEN end--- OBSERVATION REQUEST end--- ORDER end

MSH-9 - Message Type (MSG) shall have its three components respectively valued to
“
ORL”
,“
O22”a
nd“
ORL_O22”.
The ERR segment shall be used in case of negative acknowledgement (when MSA-1 = AE or
AR).

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4.5.5 OML^O33 static definition
Table 4.5-3: OML^O33
Segment

1100

Usage

Card.

HL7

MSH

Message Header

MeaningR[1..1]

2[--- PATIENT begin

O[0..1]

PID

Patient IdentificationR[1..1]

3[ PV1 ]

Patient VisitRE[0..1]

3]--- PATIENT end{--- SPECIMEN beginR[1..*]

SPM

SpecimenR[1..*]

7[{SAC}]

Specimen ContainerC[2..*]

13{--- ORDER beginR[1..*]

ORC

Common Order (for one battery)R[1..*]

4[{TQ1}]

Timing Quantity

RE[0..1]

4[--- OBSERVATION REQUEST beginR[1..1]

OBR

Observation Request

R[1..1][{

4--- OBSERVATION begin

O[0..*]

OBX

Observation ResultR[1..1][{NTE}]

Notes and comments for result

C[0..1]}]--- OBSERVATION end{--- PRIOR RESULT begin

O[0..*]

PV1

Patient Visit –previous result

RE[0..1]{--- ORDER PRIOR begin

R

[1*]

[ORC]

Common order –previous resultO[0..1]

4

OBR

Order detail –previous resultR[1..1]

4{--- OBSERVATION PRIOR beginR[1..*]

OBX

Observation/Result –previous resultR[1..1][{NTE}]

Comment of the result

C[0..*]}--- OBSERVATION PRIOR end}--- ORDER PRIOR end}--- PRIOR RESULT end]--- OBSERVATION REQUEST end}--- ORDER end}--- SPECIMEN end

7

3

2

MSH-9 - Message Type (MSG) shall have its three components respectively valued to
“
OML”
,“
O33”
,a
nd“
OML_O33”.
The conditions on the OBSERVATION segment group are the same as for OML^O21.
The condition and cardinalities on the SAC segment are the same as for OML^O21.

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4.5.6 ORL^O34 static definition
Table 4.5-4: ORL^O34
Usage

Card.

HL7 chapter

MSH

Segment

Message header

R[1..1]

2

MSA

Message AcknowledgementR[1..1]

2[{ERR}]

Error

O[0..*]

2

Patient IdentificationO[0..1]

3--- SPECIMEN beginR[1..*]

SPM

SpecimenR[1..1]

7[{SAC}]

Specimen ContainerO[0..*]

13[{--- ORDER begin

O[0..*]

ORC

Common OrderR[1..1]4[PID]{

Meaning[{TQ1}]

Timing/Quantity

RE[0..1]

4[OBR]

Observation Request

R[1..1]

4}]--- ORDER end}--- SPECIMEN end

MSH-9 - Message Type (MSG) shall have its three components respectively valued to
“
ORL”
,“
O34”a
nd“
ORL_O34”.

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4.5.7 OML^O35 static definition
Table 4.5-5 : OML^O35 static definition for transaction LAB-1
Usage

Card

MSH

Segment
Message Header

MeaningR[1..1]

HL7[--- PATIENT begin

O[0..1]

PID

Patient IdentificationR[1..1]

3[ PV1 ]

Patient VisitRE[0..1]

3]--- PATIENT end{--- SPECIMEN beginR[1..*]

SPM

SpecimenR[1..1]{--- CONTAINER beginR[1..*]

SAC

Container detailR[1..1]{--- ORDER beginR[1..*]

ORC

Common Order (for one battery)R[1..1]

4[{TQ1}]

Timing Quantity

RE[0..1]

4[--- OBSERVATION REQUEST beginR[1..1]

OBR

Observation Request

R[1..1][{--- OBSERVATION begin

O[0..*]

OBX

Observation Result

R[1..*]

7

C[0..*]

2

2

7
13

4

[{NTE}]

Comment of the result}]--- OBSERVATION end[{--- PRIOR_RESULT begin

O[0..*]

PV1

Patient Visit –previous result

RE[0..1]{--- ORDER_PRIOR beginR[1..*][ORC]

Common Order - previous resultR[1..1]

4

OBR

Order Detail - previous resultR[1..1]

4{[NTE]}

Notes and Comments - previous result

O[0..*]

2{--- OBSERVATION_PRIOR beginR[1..*]

OBX

Observation/Result - previous resultR[1..1]

7{[NTE]}

Notes and Comments - previous result--- OBSERVATION_PRIOR end--- ORDER_PRIOR end

O[0..*]

2}}}]--- PRIOR_RESULT end]--- OBSERVATION REQUEST end}--- ORDER end}--- CONTAINER end}--- SPECIMEN end

3

Field MSH-9 - Message Type (MSG) shall have its three components respectively valued to
“
OML”
,“
O35”a
nd“
OML_O35”.
The conditions on the OBSERVATION segment group are the same as for message
OML^O21.
The SAC segment below the SPM segment is mandatory in OML^O35 message structure.

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4.5.8 ORL^O36 static definition
Table 4.5-6 : ORL^O36
Usage

Card.

HL7

MSH

Segment

Message header

R[1..1]

2

MSA

Message AcknowledgementR[1..1]

2[{ERR}]

Error

O[0..*]

2

Patient IdentificationO[0..1]

3
7[PID]

Meaning{--- SPECIMEN begin
SPM

SpecimenR[1..*]{--- CONTAINER beginR[1..*]

SAC

Specimen ContainerR[0..*][{--- ORDER beginR[1..*]

13

ORC

Common OrderR[1..*]

4[{TQ1}]

Timing/Quantity

RE[0..1]

4[OBR]

Observation Request

R[1..1]

4}]--- ORDER end}--- CONTAINER end}--- SPECIMEN end

1120
MSH-9 - Message Type (MSG) shall have its three components respectively valued to
“
ORL”
,“
O36”a
nd“
ORL_O36”.
The SAC segment below the SPM is mandatory in ORL^O36 message structure.

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4.5.9 Specific segments description for transaction LAB-1
4.5.9.1 OBR - Observation Request Segment
HL7 v2.5: chapter 4 (4.5.3)
Table 4.5-7 : OBR - Observation Request Segment
SEQ

LEN

DT

Usage

Card.

2

22

EI

R

[1..1]

TBL#

00216

Placer Order Number

3

22

EI

RE

[0..1]

00217

Filler Order Number

4

250

CE

R

[1..1]

00238

Universal Service Identifier

5

2

ID

X

[0..0]

00239

Priority –OBR

6

26

TS

X

[0..0]

00240

Requested Date/Time

7

26

TS

X

[0..0]

00241

Observation Date/Time #

8

26

TS

X

[0..0]

00242

Observation End Date/Time #

9

20

CQ

X

[0..0]

00243

Collection Volume *

10

250

XCN

RE

[0..*]

00244

Collector Identifier *

11

1

ID

RE

[0..1]

00245

Specimen Action Code *

12

250

CE

X

[0..0]

00246

Danger Code

13

300

ST

X

[0..0]

00247

Relevant Clinical Information

14

26

TS

X

[0..0]

00248

Specimen Received Date/Time *

15

300

SPS

X

[0..0]

00249

Specimen Source

16

250

XCN

R

[1..1]

00226

Ordering Provider

17

250

XTN

RE

[0..2]

00250

Order Callback Phone Number

18

60

ST

X

[0..0]

00251

Placer Field 1

19

60

ST

X

[0..0]

00252

Placer Field 2

20

60

ST

X

[0..0]

00253

Filler Field 1 +

21

60

ST

X

[0..0]

00254

Filler Field 2 +

22

26

TS

X

[0..0]

00255

Results Rpt/Status Chng - Date/Time +

23

40

MOC

X

[0..0]

00256

Charge to Practice +

24

10

ID

C

[0..1]

0074

00257

Diagnostic Serv Sect ID

25

1

ID

C

[0..1]

0123

00258

Result Status +

26

400

PRL

X

[0..0]

00259

Parent Result +

27

200

TQ

X

[0..0]

00221

Quantity/Timing

28

250

XCN

C

[0..*]

00260

Result Copies To

29

200

EIP

X

[0..0]

00261

Parent

30

20

ID

X

[0..0]

00262

Transportation Mode

37

4

NM

X

[0..1]

01028

Number of Sample Containers *

40

250

CE

X

[0..0]

01031

Transport Arrangement Responsibility

41

30

ID

X

[0..0]

0224

01032

Transport Arranged

42

1

ID

X

[0..0]

0225

01033

Escort Required

43

250

CE

X

[0..0]

01034

Planned Patient Transport Comment

48

250

CWE

X

[0..0]

01646

Medically
Necessary
Procedure Reason.

0065

0124

0476

ITEM#

Element name1130
OBR-2 Placer Order Number (EI), required in transaction LAB-1.

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DuplicateIHE Laboratory Technical Framework, vol. 2: Transactions
Note that all batteries/tests contained in the order should be assigned a unique Placer Order
Number. The same identifier will never be used twice by the Order Placer. The Placer Order
Number is generated by the Order Placer actor and should be unique across all OBR
segments across all messages. Please refer to section 2.3.6.1 for the details of the data type.
OBR-3 Filler Order Number (EI), required if available.

1140

Note that all batteries/tests contained in the filler order should be assigned a unique Filler
Order Number. The same identifier will never be used twice by the Order Filler. The filler
order number is generated by the Order Filler actor and should be unique across all OBR
segments across all messages. Please refer to section 2.3.6.1 for the details of the data type.
OBR-4 Universal Service Identifier (CE), required
This field contains one ordered battery or test. A battery is composed of one or more tests or
one or more batteries.
OBR-5 Priority and OBR-6 Requested Date/Time
These two fields are not supported. See TQ1 segment.
OBR-7, OBR-8, OBR-12, OBR-14, OBR-15 These fields are not supported. See SPM
segment that supersedes them.
OBR-10 Collector Identifier, required if available.
This repeat
a
bl
ef
i
e
l
dc
ont
a
i
nst
hes
pe
c
i
me
nc
ol
l
e
c
t
or
s
’i
de
nt
i
f
i
c
a
t
i
on.

1150

OBR-11 Specimen Action Code (ID), required if available.
The value of this field is dependent on the use case as described in Volume 1.
The field identifies the action to be taken with respect to the specimens that accompany or
precede this order. The purpose of this field is to further qualify (when appropriate) thegeneral action indicated by the order control code contained in the accompanying ORC
segment.
HL7 Table 0065 - Specimen Action Code gives the valid values:
Table 4.5-8 : HL7 Table 0065 - Specimen Action Code
Value

DescriptionA

Add ordered tests to the existing specimen

G

Generated order; reflex orderL

Lab to obtain specimen from patientO

Specimen obtained by service other than Lab

P

Pending specimen; Order sent prior to delivery

R

Revised order

S

Schedule the tests specified below

Comment

OBR-13 Relevant Clinical information (ST), not supported.
1160

Transaction LAB-1 uses OBX segment to carry relevant clinical information, or a NTE
segment below the OBR for more comment orientated information.
OBR-16 Ordering Provider (XCN), required.
OBR-17 Order Callback Phone Number (XTN), required if available. One or two phone
numbers.

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OBR-22 Results Rpt/Status Chng - Date/Time (TS), not used in LAB-1: OBR-22 is related
to the RESULT, not to the ORDER. OBR-22 is related to OBR-25. ORC-9 contains thedate/time of the latest status change of the ORDER.
OBR-24 Diagnostic Serv Sect ID (ID), conditional
1170

Condition predicate: This field may be valued in OML messages sent by the Order Filler. In
other words this field is RE for the order filler actor. The valid values are defined in HL7
Table 0074 - Diagnostic Service Section ID. The table below presents a subset of these valid
values as identified in Volume 1.
Table 4.5-9 : HL7 Table 0074 - Diagnostic Service Section ID (subset)
Value

Description

Addressed by Laboratory TF 2003 - 2004

BG

Blood Gases

Yes

CH

ChemistryYesCP

Cytopathology

HM

Hematology

Yes

IMM

Immunology

Yes

LAB

Laboratory

Yes

MB

Microbiology

Yes

MCB

Mycobacteriology

Yes

MYC

Mycology

Yes

OSL

Outside Lab

SR

Serology

Yes

TX

Toxicology

Yes

VR

Virology

Yes

OBR-25 Order Result Status (ID), Conditional.
Condition predicate: This field shall not be filled in messages sent by the Order Placer. This
field shall be filled in messages sent by the Order Filler, according to HL7 Table 0123
described in Chapter 7 of HL7. In this version of the Laboratory Technical Version, thepossible values for this field are a subset of this table:
HL7 Table 0123 - Result Status
Value
O

Description
Order received; specimen not yet received

I

No results available; specimen received, procedure
incompleteS

No results available; procedure scheduled, but not
done

R

Results stored; not yet verified

P

Preliminary: A verified early result is available, final
results not yet obtainedF

Final results; results stored and verified. Can only bechanged with a corrected result.

C

Correction to results

X

No results available. Order canceled

Comment

1180
Note:

For the conditions of use of these values, please read section 3.12 “
Cor
r
el
at
i
onsofst
at
usbet
ween
ORC,OBRandOBX”.

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OBR-28 Result Copies To (XCN), conditional.
HL7 Definition: This field identifies the people who are to receive copies of the results. By
local convention, either the ID number or the name may be absent.
Condition predicate: The Order Placer shall fill this field when it sends a new order for which
there are persons or care units declared for receiving a copy of the results.

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5 Transaction LAB-2: Filler Order Management
5.1 Scope1190

This trans
a
c
t
i
oni
sus
e
dbyt
hege
ne
r
a
lus
ec
a
s
e“
Filler order with specimens identified bythird party or collected by the laboratory”de
s
c
r
i
be
di
nt
heVol
ume1oft
hi
st
e
c
hni
c
a
l
framework. It corresponds to Transaction 2 of the IHE Laboratory Technical Framework. It is
used by the Order Filler (Laboratory Information System) and the Order Placer.
This transaction is used by the Order Filler to place a new order to the Order Placer. The
order contains a list of batteries or tests to be fulfilled, using biological specimens collectedfrom the subject. A battery contains one or more tests, each of which may produce one ormore observations.

1200

The main goal of the Filler Order Management Transaction is to allow consistent
management of the order, (content and status), between the Order Filler and Order Placer
actors.

5.2 Use Case Roles

Order Placer

Order Filler

Filler Order Mgt

Actor :Order Placer
Roles : Receives filler orders. Notifies the Order Filler of acceptance or refusal. Notifies theOrder Filler of the placer order number if the filler order was accepted.
Actor :Order Filler
1210

Roles : Places filler orders by sending them to the Order Placer. Receives acceptance orrejection from the Order Placer. Receives the placer order reference number from the Order
Placer if the Order Placer accepts the order. Receives order related changes from the Order
Placer.

5.3 Referenced standards
HL7 version 2.5:

Chapter 2: "Control" --> generic segments and data types
Chapter 3: "ADT" --> PID and PV1 segmentsChapter 4: "Order Entry" --> OML and ORL messages

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Chapter 7: "Observation Reporting" --> SPM segment
Chapter 13: "Clinical Laboratory Automation" --> SAC segment

5.4 Interaction diagrams
Trigger events: In all interactions below, the initiator chooses the best OML message
structure appropriate to its orders. The responder SHALL respond with the related ORL
message structure:
OML^O21  ORL^O22
OML^O33  ORL^O34
OML^O35  ORL^O36
An OML message shall be responded to with exactly 1 ORL message.
1230

ORL messages SHALL be created by the Order Placer application, and not by a message
broker. The message broker (an intermediary between the Order Filler and the Order Placer)hasnoknowledgeoft
het
e
s
t
sbe
i
ngr
e
que
s
t
e
da
ndc
a
n’
ta
s
s
i
g
ni
de
nt
i
f
i
c
a
t
i
onnumber
sonbehalf of the Order Placer.

5.4.1 Process of a filler order
The figure below shows the flow of messages in the normal process of a filler order. A Filler
Order is placed, and responded to by either a rejection or acceptance.

1240

Note that the creation of a filler order may be triggered by a prior placer order, e.g. if theresults of one of the previously ordered tests triggers the laboratory to perform additional
tests. The creation of a filler order could also happen during the quality control performed by
the laboratory on a new order received from the Order Placer: the laboratory may then decidethat some extra battery that was not ordered should be added, e.g. regarding the pathology
context.
Order Placer

For each battery, thefiller order is acceptedor rejected. In case of
acceptance the Placer
Order is reported to
the Order Filler.

Order Filler

OML Send order/service number: ORC-1 = SNCreation of a
new filler order

ORL acknowledgement
Number assigned: ORC-1 = NA
Unable to accept order: ORC-1 = UA

Figure 5.4-1: Process of a filler order

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5.5 Messages static definitions
1250

5.5.1 Available HL7 2.5 structures for OML message
HL7 v2.5 chapter 4, offers three different message structures for the OML message type.
Transaction LAB-2 allows all message types to be used that are used by transaction LAB-1.
See paragraph 4.5.1. for a detailed description.
5.5.2 Restrictions on OML message for transaction LAB-2

1260

This cycle of Laboratory Technical Framework supports multiple message structures as
defined above, and makes the following restrictions for transaction LAB-2:

Re
s
t
r
i
c
t
st
i
mi
ng
/
qua
nt
i
t
yt
oonei
ns
t
a
nc
epe
ror
de
r(
i
.
e
.t
he
r
e
’
sonei
t
e
r
a
t
i
onoft
he
TQ1 segment related to an OBR). The main reason for this choice is that collecting
the specimens is not delegated to a separate actor in this cycle of the IHE Laboratory
Technical Framework. The collection process is part of either the Order Placer or theOrder Filler. See the explanation given in LAB-1 section.
5.5.3 OML and ORL messages static definition
The static definition of the messages in LAB-2 are equal to the static definition for LAB-1.
See paragraph 4.5.3. up to paragraph 4.5.8. for details.
5.5.4 Specific segments description for transaction LAB-2
5.5.4.1 OBR - Observation Request Segment
HL7 v2.5: chapter 4 (4.5.3)
Table 5.5-1 : OBR - Observation Request Segment
SEQ

LEN

DT

Usage

Card.

2

22

EI

X

[0..0]

00216

Placer Order Number

3

22

EI

R

[1..1]

00217

Filler Order Number

4

250

CE

R

[1..1]

00238

Universal Service Identifier

5

2

ID

X

[0..0]

00239

Priority –OBR

6

26

TS

X

[0..0]

00240

Requested Date/Time

7

26

TS

X

[0..0]

00241

Observation Date/Time #

8

26

TS

X

[0..0]

00242

Observation End Date/Time #

9

20

CQ

X

[0..0]

00243

Collection Volume *

10

250

XCN

RE

[0..*]

00244

Collector Identifier *

11

1

ID

RE

[0..1]

00245

Specimen Action Code *

12

250

CE

X

[0..0]

00246

Danger Code

13

300

ST

X

[0..0]

00247

Relevant Clinical Information

14

26

TS

X

[0..0]

00248

Specimen Received Date/Time *

15

300

SPS

X

[0..0]

00249

Specimen Source

16

250

XCN

RE

[0..1]

00226

Ordering Provider

17

250

XTN

RE

[0..2]

00250

Order Callback Phone Number

18

60

ST

X

[0..0]

00251

Placer Field 1

Rev. 1.1–Final Text 08/07/2004

54

TBL#

0065

ITEM#

Element name

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
SEQ

LEN

DT

Usage

Card.

19

60

ST

X

[0..0]

TBL#

00252

Placer Field 2

20

60

ST

X

[0..0]

00253

Filler Field 1 +

21

60

ST

X

[0..0]

00254

Filler Field 2 +

22

26

TS

X

[0..0]

00255

Results Rpt/Status Chng - Date/Time +

23

40

MOC

X

[0..0]

00256

Charge to Practice +

24

10

ID

RE

[0..1]

0074

00257

Diagnostic Serv Sect ID

25

1

ID

X

[0..0]

0123

00258

Result Status +

26

400

PRL

X

[0..0]

00259

Parent Result +

27

200

TQ

X

[0..0]

00221

Quantity/Timing

28

250

XCN

C

[0..*]

00260

Result Copies To

29

200

EIP

X

[0..0]

00261

Parent

30

20

ID

X

[0..0]

00262

Transportation Mode

37

4

NM

X

[0..1]

01028

Number of Sample Containers *

40

250

CE

X

[0..0]

01031

Transport Arrangement Responsibility

41

30

ID

X

[0..0]

0224

01032

Transport Arranged

42

1

ID

X

[0..0]

0225

01033

Escort Required

43

250

CE

X

[0..0]

01034

Planned Patient Transport Comment

48

250

CWE

X

[0..0]

01646

Medically
Necessary
Procedure Reason.

0124

0476

ITEM#

Element name

Duplicate1270
OBR-2 Placer Order Number (EI), not allowed in transaction LAB-2.
Transaction LAB-1 has to be used if the Placer Order Number is known. Please refer tosection 2.3.6.1 for the details of the data type.
OBR-3 Filler Order Number (EI), required.
Note that all batteries/tests contained in the filler order should be assigned a unique identifier.
The same identifier will never be used twice. The filler order number should be unique acrossall OBR segments across all messages ever sent by the order filler. Please refer to section
2.3.6.1 for the details of the data type.
OBR-4 Universal Service Identifier (CE), required
1280This field contains one ordered battery or test. A battery is composed of one or more tests or
one or more batteries.
OBR-5 Priority and OBR-6 Requested Date/Time
These two fields are not supported. See TQ1 segment.
OBR-7, OBR-8, OBR-12, OBR-14, OBR-15 These fields are not supported. See SPM
segment for fields that supersedes them.
OBR-10 Collector Identifier, required if available.
Thi
sr
e
pe
a
t
a
bl
ef
i
e
l
dc
ont
a
i
nst
hes
pe
c
i
me
nc
ol
l
e
c
t
or
s
’i
de
nt
i
f
i
c
a
t
i
on.
OBR-11 Specimen Action Code (ID), required if available.
The value of this field is dependent on the use case as described in volume 1.

1290

The field identifies the action to be taken with respect to the specimens that accompany or
precede this order. The purpose of this field is to further qualify (when appropriate) the

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general action indicated by the order control code contained in the accompanying ORC
segment.
HL7 Table 0065 - Specimen Action Code gives the valid values:
Table 5.5-2 : HL7 Table 0065 - Specimen Action Code
Value

Description

G

Comment

Generated order; filler order

OBR-13 Relevant Clinical information (ST), not supported.
Instead of OBR-13, transaction LAB-2 uses OBX segment to carry relevant clinicalinformation, or a NTE segment below the OBR for more comment orientated information.
1300

OBR-16 Ordering Provider (XCN), required if available.
OBR-17 Order Callback Phone Number (XTN), required if available. One or two phone
numbers.
OBR-24 Diagnostic Serv Sect ID (ID), required if available.
The valid values are defined in HL7 Table 0074 - Diagnostic Service Section ID. The tablebelow presents a subset of these valid values as identified in volume 1.
Table 5.5-3 : HL7 Table 0074 - Diagnostic Service Section ID (subset)
Value

Description

Addressed by Laboratory TF 2003 - 2004

BG

Blood Gases

Yes

CH

ChemistryYesCP

Cytopathology

HM

Hematology

Yes

IMM

Immunology

Yes

LAB

Laboratory

Yes

MB

Microbiology

Yes

MCB

Mycobacteriology

Yes

MYC

Mycology

Yes

OSL

Outside Lab

SR

Serology

Yes

TX

Toxicology

Yes

VR

Virology

Yes

OBR-28 Result Copies To (XCN), conditional.
1310

HL7 Definition: This field identifies the persons who are to receive copies of the results. By
local convention, either the ID number or the name may be absent.
Condition predicate: If there are known individuals or care units that should receive a copy ofresults related to this order, they should be listed here.

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6 Transaction LAB-3: Order Results Management
This section corresponds to Transaction 3 of the IHE Laboratory Technical Framework. It is
used by the Order Filler (Laboratory Information System) and the Order Result Tracker.

6.1 Scope1320

This transaction notifies the Order Result Tracker of requested tests upon creation of an order
or reception of a specimen in the laboratory. It transmits the observation results from theOrder Filler to the Order Result Tracker, when a result is acquired, clinically validated,
modified or deleted at the Order Filler level. Another goal of this transaction is to provide theOrder Result Tracker with the complete sorted set of results related to a placer order or aplacer order group. The Order Result Tracker shall store these results in the sorting order
given by the Order Filler.
In order to maintain consistency between order and result messages, the result messages oftransaction T3 should refer to primary specimen even in case some of the observations are
performed on secondary samples that are derived from primary specimen after specificpreparation.

1330

6.2 Use Case Roles
Order Filler

Order Results
Tracker

Order Result Mgt

Actor: Order Filler
Roles: Provides notification to the Order Result Tracker for specimen arrival, acquisition oftechnically validated results, clinical validation of results, modification/cancellation of results
and deletion of tests. Provides the complete sorted set of results related to a placer order or aplacer order group.
Actor: Order Result Tracker
1340

Roles: Receives test order and results from the Order Filler, gives access to this order andresults to the healthcare enterprise, respects the sorting order of the results as received fromthe Order Filler.

6.3 Referenced standards
Although the HL7 "ORU" message allows to transfer most laboratory observations, it
requires in frequent cases to use Child "OBR" segments that are difficult to manage both for
the Order Filler and the Order Result Tracker applications. This is the main reason why IHE
ha
sc
ho
s
e
nHL7"
OUL"me
s
s
a
ge
si
ns
t
e
a
dof“
ORU”
.
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1350

HL7 version 2.5:

Chapter 2: "Control" --> generic segments and data types
Chapter 3: "Patient Administration" --> PID and PV1 segmentsChapter 4: "Order Entry" --> OBR segment
Chapter 7: "Observation Reporting" --> OUL messages

6.4 Interaction diagrams
6.4.1 Normal process for management of results of a filler order
The figures below show the flow of messages that occurs during normal process of a filler
order, from the reception of specimen or entry of the order in the laboratory, up to thecompletion of this order and visualization of results by an end user on the Order Result
Tracker. For each triggering event of an OUL message, the value of the result status of theOBR (OBR-25) is indicated.
Order R esult
Tracker

Ord er Filler
New order received
or generated

OUL, Result status S
ACK, (applicative acknowledgement )Reception andacceptance ofspecimen

OUL, Result status I
ACK, (applicative acknowledgement )Technically validated
results available

OUL, Result status R
ACK, (applicative acknowledgement )Clinical validationof results

OUL, Result status P (partial) or F (final)
ACK, (applicative acknowledgement )Correction of
results previously
sent as clinicallyvalidated

1360

OUL, Result status C
ACK, (applicative acknowledgement )Figure 6.4-1: Normal process for management of results of a filler order

The decision whether to deliver or not technically validated results (using OBR-25“
Re
s
ul
t
St
a
t
us
”“
R”
)t
ot
heOr
de
rRe
s
ul
tTr
a
c
ke
ri
sdr
i
ve
nbyor
ga
ni
z
a
t
i
onr
ul
e
ss
pe
c
i
f
i
ct
oe
a
c
h
healthcare enterprise. These rules may take account of the order priority (TQ1-9), theordering provider, the particular ordered battery, the executing laboratory, the observation
r
e
s
ul
ti
t
s
e
l
f
… TheI
HE La
bor
a
t
or
yTe
c
hni
c
a
lFr
a
me
wor
kdoe
snotma
kea
nya
s
s
e
r
t
i
onon
these rules. It only states that an Order Filler MUST be able to send all the result statuses

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mentioned in the above diagram, and doing so, MUST conform to the correlation diagramsand transition diagrams presented in section 3.12.
1370

The same remark applies to the sending of partial clinically validated results (using OBR-25
“
Re
s
ul
tSt
a
t
us
”“
P”
)
.
6.4.2 Deletion of Battery/Test in a filler order
At any time during the process described in figure 6.4.1, a test/battery of the order can bedeleted from the filler order, which should trigger a message to the Order Result Tracker asshown below.

Figure 6.4-2: Deletion of a test by Order Filler

6.4.3 Addition of Battery/Test in a filler order1380

At any time during the process described in figure 6.4.1, a test/battery of the order can be
added in the filler order, which should trigger a message to the Order Result Tracker asshown below.

Figure 6.4-3: Addition of a test by Order Filler

6.5 Messages static definitions
6.5.1 OUL : Unsolicited Laboratory Observation message

1390

The following events from an Order Filler (LIS) will trigger an Unsolicited Laboratory
Observation (OUL) message to the Order Result Tracker:
Entry of an Order at the laboratory level for an already collected specimenReception and acceptance of a specimenAcquisition of results that are technically validated

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Clinical validation of resultsModification of already transmitted resultsCancellation of resultsAddition/Deletion of tests

1400

Among the different types of OUL messages that are described in HL7 Chapter 7, twodifferent types of OUL messages should be considered depending on the specialty of thelaboratory or more precisely to the type of observation/specimen:- The OUL –Unsolicited Specimen Oriented Observation Message - (Event R22).
- The OUL –Unsolicited Order Oriented Observation Message - (Event R24)
The OUL^R22 message structure shall be used for all orders for which each ordered battery
requires a single specimen.
The OUL^R24 message structure shall be used when an ordered battery requires multiple
specimens (e.g. glucose tolerance test, creatinine clearance).

1410

In both message structures the order in which the OBX segments appear defines thesorting order for the presentation of the results for a given battery or specimen. In thisrespect, the Order Filler shall transmit all available results for the battery or specimen
in recapitulative mode whether they have already been transmitted or not.
6.5.1.1 OUL^R22 static definition
Table 6.5-1 : OUL^R22 static definition
Segment

Meaning

Usage

Card.

HL7 chapter
2

MSH

Message Header

R[1..1][--- PATIENT begin

O[0..1]

PID

Patient IdentificationR[1..1]

3[ PV1 ]

Patient VisitRE[0..1]

3]--- PATIENT end[{--- SPECIMEN beginR[1..*]

SPM

SpecimenR[1..1][{OBX}]

Observation related to specimen

O[0..*][{--- ORDER beginR[1..*]

OBR

Observation Request

R[1..*]

4[ORC]

Common Order (for one specimen)

R[1..1]

4[{TQ1}]

Timing Quantity

RE[0..1]

4[{--- RESULT begin

O[0..*]

OBX

Observation related to OBR

R[1..*]

7[{NTE}]

Comment of the result

C[0..*]

2}]--- RESULT end}]--- ORDER end}]--- SPECIMEN end

7

Field MSH-9 – Message Type shall have its three components valued as follows:
OUL^R22^OUL_R22
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For specimen oriented observation message, additional parameters that are related to thespecimen (e.g.: Anatomic origin, Collection procedure) should be transmitted in OBX
segments that immediately follow the SPM segment..
1420

For each set of observations (e.g. Microscopy; Culture; Antibiotic Susceptibility ) the Order
Filler should generate an OBR segment that identifies the Observation followed by a series of
OBX segments, each of them carrying the result of an individual test/observation.
Following the SPM segment, the Order Filler should systematically transmit in the OUL
message, all OBR and OBX segments related to this SPM. This systematic transmission of allobservations linked to an SPM segment and their respective status may help the Order Result
Tracker to recover from an error situation, when for some hazardous reasons a previous OUL
message for the same request could not have been properly processed. For the same reason
the "U" value should not be used in the Observation Result Status field of an OBX segment(see description of this segment in section 3.11of this document).

1430

In case an observation previously transmitted is deleted, the Order Filler should transmit all
OBX segments linked to the OBR to which the deleted observation relates to; and it should
indicate the current status of each OBX segment. The Observation Result Status field of the
OBX that correspond to the deleted observation should be valued with a "D".
Unless the Report Status field (OBR-25) of the OBR is valued with an "X" (deleted battery),the OBR segment shall always be followed by one or several OBX segments.
TQ1 and ORC segments shall be transmitted because they contain important informationsuch as the priority of the order and the order group number.

6.5.1.2 OUL^R24 static definition
1440

Table 6.5-2 : OUL^R24 static definition
Segment

Meaning

Usage

Card.

HL7 chapter
2

MSH

Message Header

R[1..1][--- PATIENT begin

O[0..1]

PID

Patient IdentificationR[1..1]

3[ PV1 ]

Patient VisitRE[0..1]

3]--- PATIENT end{--- ORDER beginR[1..*]

OBR

Observation Request

R[1..1]

4[ORC]

Common Order (for one battery)R[1..1]

4[{TQ1}]

Timing Quantity

RE[0..1]

4[{--- SPECIMEN begin

O[0..*]

SPM

SpecimenR[1..1][{OBX}]

Observation related to specimen

O[0..*]}]--- SPECIMEN end[{--- RESULT beginR[1..*]

OBX

Observation related to OBR

R[1..1]

7

C[0..*]

2[{NTE}]

Comment of the result}]--- RESULT end}--- ORDER end

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Field MSH-9 – Message Type shall have its three components valued as follows:
OUL^R24^OUL_R24
Depending on the requested test, additional parameters may be needed such as, patient height,
weight or last menstrual period. These data that are results of observation not related to any
specimen but generally related to the patient; should be transmitted in a series of OBX
segments that immediately follows the OBR segment and that precedes the first SPM
segment related to the requested battery.
1450

Although in most of cases there is only one specimen related to the OBR segment, forbatteries such as Creatinine Clearance or Glucose Tolerance test, there may be several
specimens related to the OBR. In such a case, each SPM segment is followed by OBX
segment(s) of observation(s) related to this particular specimen.
OBX that carry results of a calculation (e.g. Creatinine Clearance) that involves observation
values related to several specimens should be placed after the last observation related to thelast specimen.

1460

Following the OBR, the Order Filler should systematically transmit in the OUL message, all
OBX and SPM segments related to this OBR. This systematic transmission of allobservations linked to an OBR and their respective status may help the Order Result Tracker
to recover from error situation, when for some hazardous reasons a previous OUL message
for the same request could not have been properly processed. For the same reason the "U"value should not be used in the Observation Result Status field of an OBX segment (seedescription of this segment in Chapter 3.11 earlier in this document).
In case an observation previously transmitted is deleted, the Order Filler should transmit all
OBX segments linked to the OBR to which the deleted observation relates to; and it should
indicate the current status of each OBX segment. The Observation Result Status field of the
OBX that correspond to the deleted observation should be valued with a "D".
Unless the Report Status field (OBR-25) of the OBR is valued with an "X" (deleted battery),the OBR segment shall always be followed by one or several SPM and OBX segments.

1470

TQ1 and ORC segments shall be transmitted because they contain important informationsuch as the priority of the order and the order group number.
6.5.1.2.1 OBR Segment
The OUL message corresponding to an Order should contain as many OBR segments asrequested batteries or requested tests involved by the triggering event of the message. For
example, upon reception of a specimen in the laboratory, the Order Filler (LIS) will generate
an OUL message that contains as many OBR segments as batteries or tests requested for thisspecimen. The modification of a result of an observation will trigger an OUL message that
contains the OBR segment for the battery that includes this observation.
Table 6.5-3 : OBR segment
SEQ

LEN

DT

Usage

Card.

2

22

EI

RE

[0..1]

00216

Placer Order Number

3

22

EI

R

[1..1]

00217

Filler Order Number

4

250

CE

R

[1..1]

00238

Universal Service Identifier

5

2

ID

X

[0..0]

00239

Priority –OBR

6

26

TS

X

[0..0]

00240

Requested Date/Time

7

26

TS

X

[0..0]

00241

Observation Date/Time

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62

TBL#

ITEM#

Element name

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
SEQ

LEN

DT

Usage

Card.

8

26

TS

X

[0..0]

TBL#

00242

Observation End Date/Time

9

20

CQ

X

[0..0]

00243

Collection Volume

10

250

XCN

RE

[0..1]

00244

Collector Identifier

11

1

ID

C

[0..1]

00245

Specimen Action Code

12

250

CE

X

[0..0]

00246

Danger Code

13

300

ST

X

[0..0]

00247

Relevant Clinical Information

14

26

TS

X

[0..0]

00248

Specimen Received Date/Time

15

300

SPS

X

[0..0]

00249

Specimen Source or Segment SPM

16

250

XCN

RE

[0..1]

00226

Ordering Provider

17

250

XTN

X

[0..0]

00250

Order Callback Phone Number

18

60

ST

X

[0..0]

00251

Placer Field 1

19

60

ST

X

[0..0]

00252

Placer Field 2

20

60

ST

X

[0..0]

00253

Filler Field 1

21

60

ST

X

[0..0]

00254

Filler Field 2

22

26

TS

X

[0..0]

00255

Results Rpt/Status Chng –Date/Time

23

40

MOC

X

[0..0]

00256

Charge to Practice

24

10

ID

R

[0..0]

0074

00257

Diagnostic Serv Sect ID

25

1

ID

R

[1..1]

0123

00258

Order Result Status

26

400

PRL

X

[0..0]

00259

Parent Result

27

200

TQ

X

[0..0]

00221

Quantity/Timing

28

250

XCN

RE

[0..*]

00260

Result Copies To

29

200

EIP

X

[0..0]

00261

Parent

30

20

ID

X

[0..0]

00262

Transportation Mode

31

250

CE

X

[0..0]

00263

Reason for Study

32

200

NDL

C

[0..1]

00264

Principal Result Interpreter

33

200

NDL

X

[0..0]

00265

Assistant Result Interpreter

34

200

NDL

X

[0..0]

00266

Technician

37

4

NM

X

[0..0]

01028

Number of Sample Containers *

38

250

CE

X

[0..0]

01029

Transport Logistics of Collected Sample

39

250

CE

X

[0..0]

01030

Collector's Comment *

40

250

CE

X

[0..0]

01031

Transport Arrangement Responsibility

41

30

ID

X

[0..0]

0224

01032

Transport Arranged

42

1

ID

X

[0..0]

0225

01033

Escort Required

43

250

CE

X

[0..0]

01034

Planned Patient Transport Comment

44

250

CE

X

[0..0]

0088

00393

Procedure Code

45

250

CE

X

[0..0]

0340

01316

Procedure Code Modifier

46

250

CE

X

[0..0]

0411

01474

Placer
Supplemental
Information

47

250

CE

X

[0..0]

0411

01475

Filler Supplemental Service Information

48

250

CWE

X

[0..0]

0476

01646

Medically
Necessary
Procedure Reason.

49

2

IS

X

[0..0]

N

01647

Result Handling

0065

0124

ITEM#

Element name1480

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63

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHIS

Service

DuplicateIHE Laboratory Technical Framework, vol. 2: Transactions
OBR-2 Placer Order Number (EI)
This field is required if the value is known to the sender. See section 2.3.6.1 for the detailsof the data type. In case of a Filler Order, the value of this field will be known to thesender after transaction LAB-2 Filler Order Management (section 5.4.1) has taken place.
OBR-3 Filler Order Number (EI)
This field is required. It allows the Order Result Tracker to link all the Tests/results of arequest together. It also identifies the order at the Order Filler level. Please refer to section
2.3.6.1 for the details of the data type.
1490

OBR-4 Universal Service Identifier (CE), required
The first three sub-f
i
e
l
ds“
I
de
nt
i
f
i
e
r
”
,“
Te
xt
”a
nd“
Na
meofCodi
ngSy
s
t
e
m”a
r
er
e
qui
r
e
d.
The second sub-f
i
e
l
d“
Te
xt
”a
l
l
owst
heOr
de
rRe
s
ul
tTr
a
c
ke
rt
oma
na
get
her
e
s
ul
t
s
without the help of Battery Master File.
The last three sub-fields are optional.
OBR-7 Observation Date/Time (TS)Since all observations linked to a requested battery or test, are not necessarily performedat the same time, this field should not be used. Date and time of observation (OBX-14)
should be used instead.
OBR-9 Collection Volume (CQ)

1500

Since when it is needed by the laboratory and reported, the volume of collection is theresult of an observation (sometimes done by the Order Placer) that can be used for
calculation of other results (e.g. Creatinine Clearance); this information should betransferred in an OBX segment as all other results of observation. This field OBR-9
should consequently not be used in this transaction.
OBR-10 Collector Identifier (XCN)
This field identifies the person, department or facility that collected the specimen(s).
OBR-11 Specimen Action Code (ID)1510

This field is only required in the following events:
The order is entered at the Order Filler (LIS) level as described in section 3.1.3 ofLaboratory Technical Framework Volume 1. The value of the Action Code is A.
The battery or test has been added by the Order Filler (LIS) for confirmation of adiagnostic (reflex testing); value G.
In all other triggering events of this transaction, this Action Code field is meaningless.
OBR-12 Danger Code (CE)This field should not be used in this first version of Laboratory Technical Framework.
OBR-13 Relevant Clinical Information (ST)

1520

Since it is stated in the HL7 V2.5 Chapter 7 that "for some orders this information may besent on a more structured form as a series of OBX segments (see HL7 V2.5 Chapter 7)that immediately follow the order segment", it is preferable and more consistent tosystematically use OBX segments in OUL message for sending Clinical Information.

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OBR-14 Specimen Received Date/Time (TS)This field should not be used; this information should be transmitted in an SPM segment.
OBR-15 Specimen Source (SPS)
As for OBR-13, if this information needs to be transmitted to the Order Result Tracker it
is more consistent to transfer it in an OBX segment. This field should not be used.
OBR-16 Ordering Provider (XCN)
This field is required if it was part of the order sent by the Order Placer.
OBR-24 Diagnostic Serv Sect ID (ID)1530

This field is required. In case the Order Result Tracker receives part of the results of an
entire order at different time, the Order Result Tracker can use this field for presenting all
the batteries/test with the same Diagnostic Serv. Sect. ID together.
OBR-25 Result Status (ID)

1540

1550

1560

This field is required and should be filled according to HL7 Table 0123 described in
Chapter 4. Depending on the triggering event of the OUL message the possible values forthis field are:
Value I is used to indicate reception of specimen(s) at the laboratory. In case abattery or test requires more than one specimen (e.g. Creatinine clearance) this I
status has to be used when all the required specimens have been received. An
OBR segment with this I status may be followed by OBX segments that contains
result of observations performed at specimen collection time (e.g. Volume ofcollected specimen).
Value R, to indicate that some results are available and technically validated but
not yet clinically validated.
Value P, to indicate that some of the results, but not all, are available and havebeen clinically validated. The identity of the Clinical Expert should in this case be
indicated in the OBR-32 field.
Value F, to indicate that all results are available and have been clinically validated.
The identity of the Clinical Expert should in this case be indicated in the OBR-32
field.
Value C, to indicate that at least one result contained in one of the following OBX
segments has been modified after the results have been transmitted with the F
status. This C value should never be used before results have been transmittedwith the F status. Since a Corrected result is supposed to be clinically validated,
the identity of the Clinical Expert should be indicated in the OBR-32 field whenthe value of the Result Status is C.
Value X, to indicate that the battery/test has been deleted. This deletion could
have been, either received from the Order Placer for an already received specimen
and accepted by the Order Filler, or decided by the laboratory. This value X
should not be used if some results for this test have already been transmitted.
Value S, although the usage of this value is mainly in response to a Querymessage. It can be used in OUL messages for tests that have been added to theoriginal request by the Order Filler (LIS). In this case, the value of the OBR-11
field (Action Code) should be either A, or G.

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Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
Note:

For the conditions of use of these values, please read section 3.12 “
Cor
r
el
at
i
onsofst
at
usbet
ween
ORC,OBRandOBX”.

OBR-28 Result Copies To (XCN)
1570

This field may be used to indicate the list of recipients who will receive a hard copy of theresults report, which may be useful information for users who have access to these results.
OBR-32 Principal Result Interpreter (NDL)
This field is required when the value of the Results Status field (OBR-25) is P, F or C
(corrected results are supposed to be verified). The field identifies who validated theresults, where, and when this clinical validation was performed. It describes completely
t
he“
Cl
i
ni
c
a
lVa
l
i
da
t
i
on”s
t
e
p.
OBR-33 Assistant Result Interpreter (NDL)
This field is meaningless when the value of the Result Status field is different from P, F
or C.
OBR-34 Technician (NDL)

1580

This field should not be used, as all observations linked to the battery have not necessarily
been performed by the same Technician. The OBX-16 (Responsible Observer) should be
used instead.
OBR-35 Transcriptionist (NDL)
This field is only applicable when the final report has been dictated and transcribed,
which is frequent for Histology and Cytology reports.
OBR-36 Scheduled - Date/Time (TS)This field is optional and only applies when the value of the Result Status field (OBR-25)
is S.
OBR-44 Procedure Code (CE)

1590

This field is in principle meaningless in an OUL message sent by a Laboratory but may
be needed in some organizations.
OBR-45 Procedure Code Modifier (CE)This field can be used only when OBR-44 (Procedure Code) is filled.

6.6 Acknowledgement of OUL messages
OUL Messages received by the Order Result Tracker shall generate a logicalacknowledgement message from the Order Result Tracker to the Order Filler. This General
Acknowledgement Message‘
ACK’s
ha
l
lbebui
l
ta
c
c
or
di
ngt
oHL7V2.
5s
t
a
nda
r
d.

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66

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

7 Transaction LAB-4: Work Order Management
7.1 Scope
1600

This transaction is used if the Order Filler issues a new order to the Automation Manager.
In addition, this transaction is used to cancel and/or modify an order that was previously sent
to the Automation Manager.
It is also possible to cancel a previous order and send a new order to modify it.

7.2 Use case roles

Order Filler

Automation
ManagerWork Order Mgt

Actor: Order Filler
1610

The role: manages orders and takes care of the routing to the appropriate Automation
Manager.
Actor: Automation Manager
The role: receives the orders from the order filler and manages the preprocessing, the analysis,
and the post processing of the order.

7.3 Referenced standards
HL7 version 2.5 Chapter 4

7.4 Interaction diagrams

1620

ORL messages SHALL be created by the Automation Manager application, and not by amessage broker. The message broker (an intermediary between the Order Filler and theAutomation Manager) has no knowledge of the tests being requested a
ndc
a
n’
ta
c
c
e
p
t
/
r
e
j
e
c
t
these test on behalf of the Automation Manager.

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Automation
Manager

Order Filler

OML^O21, O33, O35
New Order (ORC-1: NW)
ORL^O22, O34, O36
Order accepted (ORC-1: OK)
Unable to accept (ORC-1: UA)OML^O21, O33, O35
Order Modify (ORC-1: RP)
ORL^O22, O34, O36
Order modified

OML^O21, O33, O35
Order Cancel (ORC-1: CA)ORL^O22, O34, O36
Order cancelled

Figure 7.4-1: Normal process of ordering to Automation Manager

An OML message shall be responded to with exactly 1 ORL message.
Notes: ORM^O01 is not used, and OML^O21 bears the usage. ORR^O02 is not used either, and ORL^O22
bears the usage.

1630

7.5 Messages static definitions
7.5.1 Laboratory Order Message (OML^O21, ORL^O22)
The following message is used for analytical messages where it is required that theSpecimen/Container information is within ORC/OBR segment group.
7.5.1.1 Trigger events
OML(O21) : Work order sent by the Order Filler.
ORL (O22) : Acknowledgement of the Work Order sent by the Automation Manager.
7.5.1.2 Message semantics
1640

Refer to the HL7 standard for the OML message of HL7 2.5 Chapter 4 and the generalmessage semantics.
In addition, when the Order Filler sends a new work order to the Automation Manager, ORC1“
Or
de
rCont
r
olCode
”i
sva
l
ue
dwi
t
h“
NW”
.Whe
nt
hewor
korder is canceled, ORC-1 is
va
l
ue
dwi
t
h“
CA”
.Thec
or
r
e
c
t
i
onoft
hewor
kor
de
rus
e
sva
l
ue“
RP”
.
TheOBX s
e
g
me
nt
sa
r
eus
e
dt
oc
onve
yt
hepa
t
i
e
nt
’
spr
e
vi
ousr
e
s
ul
t
s
,a
swe
l
la
ss
ome
observation provided by the Order Placer or by the Order Filler, such as: blood pressure,
pa
t
i
e
nt
’
st
e
mpe
r
a
t
ur
e
,s
pe
c
i
me
nc
ol
l
e
c
t
i
onvol
ume
…

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Table 7.5-1: OML^021 Message
Usage

Card.

HL7 chapter

MSH

Segment

Message Header

R[1..1]

2[--- PATIENT begin

O[0..1]

PID

Patient IdentificationR[1..1]

3[ PV1 ]

Patient VisitRE[0..1]

3]--- PATIENT end{--- ORDER beginR[1..*]

ORC

Common Order (for one battery)R[1..1]

4[{TQ1}]

Timing Quantity

RE[0..1]

4[--- OBSERVATION REQUEST begin

O[0..1]

OBR

Observation Request

R[1..1]

4[TCD]

Test Code Details

O[0..1]

13[{--- OBSERVATION begin

O[0..*]

OBX

Observation ResultR[1..1]

7[{NTE}]

Comment of the result

C[0..*]

2}]--- OBSERVATION end[{--- SPECIMEN begin

C[0..*]

SPM

SpecimenR[1..1][{--- CONTAINER begin

C[0..*]

SAC

Specimen ContainerR[1..1]

13[{OBX}]

Additional specimen characteristics

O[0..*]

7

}]

1650

Meaning

7--- CONTAINER end}]--- SPECIMEN end]--- OBSERVATION REQUEST end}--- ORDER end

Field MSH-9 – Message Type shall have its three components valued as follows:
OML^O21^OML_O21
PV1 is optional in the LAB-4/LAB-5 segments since Automation manager and analytical
instruments do not usually need the outpatient information.
The SPECIMEN group is required when the specimen has already been collected andprepared, and is registered in the Order Filler application. In this case, there is at least one
SPM segment present in this group. Below each SPM segment, the condition of use of the
SAC segment is the one described in the paragraph describing this segment, section 3.10.
If neither Automation Manager nor analytical instruments compare the test result with theprevious result, ORC, OBR, and OBX for the previous result are not necessary.

1660

The OBX segment in the OBSERVATION group is used for the vital signs if it is necessary
for technical validation.
The OBX segment in the CONTAINER group is used when a rerun is ordered.
Table 7.5-2 : ORL^O22 Message
Segment

Rev. 1.1–Final Text 08/07/2004

Meaning

69

Usage

Card.

HL7 chapter

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
MSH

Message header

R[1..1]

2

MSA

Message AcknowledgementR[1..1]

2[{ERR}]

Error

O[0..*]

2[--- PATIENT begin

O[0..*]

Patient IdentificationR[1..1]PID

3--- PATIENT end]--- ORDER beginR[1..*]

ORC

Common OrderR[1..*]

4[{TQ1}]

Timing/Quantity

RE[0..1]

4[{--- OBSERVATION REQUEST begin

O[0..1]

OBR

Observation Request

R[1..1][{--- SPECIMEN begin

C[0..*]

SPM

SpecimenR[1..1]

7[{SAC}]

Specimen Container Details

C[0..*]

7

}]
]

}]

--- SPECIMEN end]--- OBSERVATION end

4--- OBSERVATION REQUEST end--- ORDER end

Field MSH-9 – Message Type shall have its three components valued as follows:
ORL^O22^ORL_O22
The PID, ORC and OBR segments are required in this message, to give back the filler ordernumber (ORC-3 or OBR-3).
The use conditions of SPM/SAC are the same as that of OML^O21.
1670

7.5.2 Laboratory Order for Multiple Orders Related to a Single Specimen(OML^O33, ORL^O34)
7.5.2.1 Trigger Events
OML (O33): Work order sent by the Order Filler.
ORL (O34): Acknowledgement of the Work Order sent by the Automation Manager.
The trigger event for this message i
s“
a
nys
t
a
t
usc
ha
ngeofawor
kor
de
r
”
.Suc
hc
ha
ng
e
s
include submission of new orders, cancellations, updates, etc where multiple orders areassociated with a single specimen, which may be carried in multiple containers.
7.5.2.2 Message semantics

1680

Refer to the HL7 standard for the OML message of HL7 2.5 Chapter 4 and the generalmessage semantics.
In addition, when the Order Filler sends a new work order to the Automation Manager, ORC1“
Or
de
rCont
r
olCode
”i
sva
l
ue
dwi
t
h“
NW”
.Whe
nt
hewor
kor
de
ri
sc
a
nc
e
l
e
d,ORC-1 is
va
l
ue
dwi
t
h“
CA”
.Thec
or
r
e
c
t
i
onoft
hewor
kor
de
rus
e
sva
l
ue“
RP”
.
TheOBX s
e
g
me
nt
sa
r
eus
e
dt
oc
onve
yt
hepa
t
i
e
nt
’
spr
e
vi
ousr
e
s
ul
t
s
,a
swe
l
la
ss
ome
observation provided by the Order Placer or by the Order Filler, such as: blood pressure,
pa
t
i
e
nt
’
st
e
mpe
r
a
t
ur
e
,s
pe
c
i
me
nc
ol
l
e
c
t
i
onvol
ume
…
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Table 7.5-3: OML^O33
Segment

1690

Usage

Card.

HL7 chapter

Message Header

R[1..1]

2--- PATIENT begin

O[0..1]

PID

Patient IdentificationR[1..1]

3

RE[0..1]

3

MSH[

Meaning[ PV1 ]

Patient Visit]--- PATIENT end{--- SPECIMEN beginR[1..*]

SPM

SpecimenR[1..1][{SAC}]

Specimen ContainerO[0..*]{--- ORDER beginR[1..*]

ORC

Common Order (for one battery)R[1..1]

4[{TQ1}]

Timing Quantity

RE[0..1]

4[--- OBSERVATION REQUEST begin

O[O..1]

OBR

Observation Request

R[1..1]

4

[TCD]

7

Test Code Details

O[0..1]

13[{OBX}]

Observation Result

C[0..*]

7{--- PRIOR RESULT startO[0..*][ORC]

Common order –prior resultO[0..1]

4

OBR

Order detail –prior resultR[1..1]

4{OBX}

Observation/Result –prior result

R[1..*][{NTE}]

Comment of the result

C[0..*]}--- PRIOR RESULT end]--- OBSERVATION REQUEST end}--- ORDER end}--- SPECIMEN end

2

Field MSH-9 – Message Type shall have its three components valued as follows:
OML^O33^OML_O33
Table 7.5-4: ORL^O34
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message header

R[1..1]

2

MSA

Message AcknowledgementR[1..1]

2[{ERR}]

Error

O[0..*]

2[PID]

Patient IdentificationO[0..1]

3{--- SPECIMEN beginR[1..*]

SPM

SpecimenR[1..1]

7[{SAC}]

Specimen ContainerO[0..*]

13[{--- ORDER begin

O[0..*]

ORC

Common OrderR[1..1]

4[{TQ1}]

Timing/Quantity

RE[0..1]

4[OBR]

Observation Request

R[1..1]

4}]--- ORDER end

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71

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Notes HL7 V2.5 Chapter 4 describe SPM and SAC under OBR segment. But, we cannot find out the necessityof them.

Field MSH-9 – Message Type shall have its three components valued as follows:
ORL^O34^ORL_O34
1700

Please refer to the section 7.5.1 (OML^O21) and ORL^O22), for a detailed description of thesegments composing the above messages.
7.5.3 Laboratory Order for Multiple Orders related to a Single Container of aSpecimen (OML^O35, ORL^O36)
7.5.3.1 Trigger Events
OML (O35): Work order sent by the Order Filler.
ORL (O36): Acknowledgement of the Work Order sent by the Automation Manager.
The trigger event for this message is any change to a laboratory order. Such changes include
submission of new orders, cancellations, updates, etc where multiple orders are associatedwith a single container of a specimen.

1710

Not
esHL7V2.
5Chapter4des
cr
i
bes“
Thet
r
i
gger event for this message is any change to a laboratory order.
Such changes include submission of new orders, cancellations, updates, etc where multiple ordersareassoci
at
edwi
t
hasi
ngl
es
ampl
ewhi
chmaybecar
r
i
edi
namul
t
i
pl
econt
ai
ner
”
.Thi
si
ss
ameas
OML^O33, and it seems a miss of typing.

7.5.3.2 Message Semantics
Refer to the HL7 standard for the OML message of HL7 2.5 Chapter 4 and the generalmessage semantics.
In addition, when the Order Filler sends a new work order to the Automation Manager, ORC1“
Or
de
rCont
r
olCode
”i
sva
l
ue
dwi
t
h“
NW”
.Whe
nt
hewor
kor
de
ri
sc
a
nc
e
l
e
d,ORC-1 is
va
l
ue
dwi
t
h“
CA”
.Thec
or
r
e
c
t
i
onoft
hewor
kor
de
rus
e
sva
l
ue“
RP”
.
1720

TheOBX s
e
g
me
nt
sa
r
eus
e
dt
oc
onve
yt
hepa
t
i
e
nt
’
spr
e
vi
ousr
e
s
ul
t
s
,a
swe
l
la
ss
ome
observation provided by the Order Placer or by the Order Filler, such as: blood pressure,
pa
t
i
e
nt
’
st
e
mpe
r
a
t
ur
e
,s
pe
c
i
me
nc
ol
l
e
c
t
i
onvol
ume
…
Table 7.5-5 : OML^O35
Segment

Meaning

Usage

Card.

HL7 chapter
2

MSH

Message header

R[1..1][--- PATIENT begin

O[0..1]

PID

Patient identificationR[1..1]

3[PV1]

Patient visit

RE[0..1]

3]--- PATIENT end{--- SPECIMEN beginR[1..*]

SPM

SpecimenR[1..1]{--- CONTAINER beginR[1..*]

SAC

Specimen ContainerR[1..1]{--- ORDER beginR[1..*]

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7
13

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ORC

Common orderR[1..1]

4[{TQ1}]

Timing/Quantity Order SequenceRE[0..1]

4[--- OBSERVATION REQUEST begin

O[0..1]

OBR

Observation Request

R[1..1]

4[ TCD ]

Test Code Details

O[0..1]

13[{OBX}]

Additional specimen characteristics

O[0..*]

7{--- PRIOR RESULT startO[0..*][ORC]

Common order –prrior resultO[0..1]

4

OBR

Order detail –prior resultR[1..1]

4{OBX}

Observation/Result - prior result

R[1..*]

7}--- PRIOR RESULT end]--- OBSERVATION REQUEST end}--- ORDER end}--- CONTAINER end}--- SPECIMEN end

Field MSH-9 – Message Type shall have its three components valued as follows:
OML^O35^OML_O35
Table 7.5-6 : ORL^O36
Segment

Usage

Card.

HL7 chapter

MSH

Message header

R

2

MSA

Message Acknowledgement

R

2[{ERR}]

Error

O

[PID]

Patient IdentificationO[0..1]{--- SPECIMEN beginR[1..*]

2
3

SPM

SpecimenR[1..1]{--- CONTAINER beginR[1..*]

SAC

Specimen ContainerR[1..1][{--- ORDER begin

O[0..*]

ORC

Common OrderR[1..1]

4[{TQ1}]

Timing/Quantity

RE[0..1]

4

Observation Request

R

[OBR]

1730

Meaning}]--- ORDER end}--- CONTAINER end]--- SPECIMEN END

7
13

4

Field MSH-9 – Message Type shall have its three components valued as follows:
ORL^O36^ORL_O36

7.5.3.2.1 OBR segment
All fields are optional except those listed in table below.

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Table 7.5-7 : OBR Segment
SEQ

LEN

DT

Usage

Card.

1

4

SI

O

[0..1]

00237

Set ID –OBR

2

22

EI

R

[1..1]

00216

Placer Order Number

3

22

EI

RE

[0..1]

00217

Filler Order Number

4

250

CE

R

[1..1]

00238

Universal Service Identifier

5

2

ID

X

[0..0]

00239

Priority –OBR

6

26

TS

X

[0..0]

00240

Requested Date/Time

7

26

TS

X

[0..0]

00241

Observation Date/Time #

8

26

TS

X

[0..0]

00242

Observation End Date/Time #

9

20

CQ

X

[0..0]

00243

Collection Volume *

10

250

XCN

O

[0..*]

00244

Collector Identifier *

11

1

ID

RE

[0..1]

00245

Specimen Action Code *

12

250

CE

X

[0..0]

00246

Danger Code

13

300

ST

X

[0..0]

00247

Relevant Clinical Information

14

26

TS

X

[0..0]

00248

Specimen Received Date/Time *

15

300

SPS

X

[0..0]

00249

Specimen Source

16

250

XCN

R

[1..1]

00226

Ordering Provider

17

250

XTN

RE

[0..2]

00250

Order Callback Phone Number

18

60

ST

X

[0..0]

00251

Placer Field 1

19

60

ST

X

[0..0]

00252

Placer Field 2

20

60

ST

X

[0..0]

00253

Filler Field 1 +

21

60

ST

X

[0..0]

00254

Filler Field 2 +

22

26

TS

X

[0..0]

00255

Results Rpt/Status Chng - Date/Time +

23

40

MOC

X

[0..0]

00256

Charge to Practice +

24

10

ID

C

[0..1]

0074

00257

Diagnostic Serv Sect ID

25

1

ID

X

[0..0]

0123

00258

Result Status +

26

400

PRL

X

[0..0]

00259

Parent Result +

27

200

TQ

X

[0..0]

00221

Quantity/Timing

28

250

XCN

O

[0..*]

00260

Result Copies To

29

200

EIP

X

[0..0]

00261

Parent

30

20

ID

X

[0..0]

00262

Transportation Mode

31

250

CE

O

[0..1]

00263

Reason for Study

32

200

NDL

O

[0..1]

00264

Principal Result Interpreter +

33

200

NDL

O

[0..1]

00265

Assistant Result Interpreter +

34

200

NDL

O

[0..1]

00266

Technician +

35

200

NDL

O

[0..1]

00267

Transcriptionist +

36

26

TS

O

[0..1]

00268

Scheduled Date/Time +

37

4

NM

O

[0..1]

01028

Number of Sample Containers *

38

250

CE

O

[0..1]

01029

Transport Logistics of Collected Sample
*

39

250

CE

O

[0..1]

01030

Collector's Comment *

40

250

CE

X

[0..0]

01031

Transport Arrangement Responsibility

41

30

ID

X

[0..0]

0224

01032

Transport Arranged

42

1

ID

X

[0..0]

0225

01033

Escort Required

43

250

CE

X

[0..0]

01034

Planned Patient Transport Comment

Rev. 1.1–Final Text 08/07/2004

74

TBL#

0065

0124

ITEM#

Element name

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
SEQ

LEN

DT

Usage

Card.

TBL#

ITEM#

44

250

CE

O

[0..1]

0088

00393

Procedure Code

Element name

45

250

CWE

O

[0..1]

0340

01316

Procedure Code Modifier

46

250

CE

O

[0..1]

0411

01474

Placer
Supplemental
Information

47

250

CE

O

[0..1]

0411

01475

Filler Supplemental Service Information

48

250

CWE

X

[0..0]

0476

01646

Medically
Necessary
Procedure Reason.

49

2

IS

O

[0..1]

0507

01647

Result Handling

Service

Duplicate

OBR-2 Placer Order Number shall be reflected in a test result (LAB-5:OUL message), and it
is used to in order that Order Filler or Order Placer use it to pull out the corresponding order
record.
1740

OBR-3 If Filler Order Number present, it should be filled in.

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7.5.3.2.2 TCD segment
All fields are optional except those listed in table below.
Table 7.5-8 : TCD Segment
SEQ

LEN

DT

Usage

Card.

1

250

CE

R

[1..1]

TBL#

ITEM#
00238

Universal Service Identifier

Element name

2

20

SN

O

[0..1]

01420

Auto-Dilution Factor

3

20

SN

O

[0..1]

01421

Rerun Dilution Factor

4

20

SN

O

[0..1]

01422

Pre-Dilution Factor

5

20

SN

O

[0..1]

01413

Endogenous
Diluent

6

1

ID

O

[0..1]

0136

01416

Automatic Repeat Allowed

7

1

ID

O

[0..1]

0136

01424

Reflex Allowed

8

250

CE

O

[0..1]

0389

01425

Analyte Repeat Status

Contentof

Pre-Dilution

7.5.3.3 Expected Action
If the OML message of the Order Control Code NW is received from Order Filler, theAutomation Manager will receive and register the order information, then it will transmit the
r
e
s
ul
te
i
t
he
r“
Ac
c
e
pt
”or“
Re
j
e
c
t
”t
oOr
de
rFi
l
l
e
rbyt
heORL message.
1750

If the OML message of the Order Control Code CA is received from Order Filler,
Automation Manager will cancel the existing previous order information, and will not try toschedule or execute the command. Moreover, the command that has already started at the
Automation Manager is not canceled. The result either Accept or Reject is transmitted toOrder Filler by the ORL message.
Automation Manager will change and register record of the command, if the OML messageof the Order Control Code RP is received from Order Filler. However, Automation Manager
does not change the command that has already started. The result either Accept or Reject istransmitted to Order Filler by the ORL message.

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1760

8 Transaction LAB-5: Test Results Management
This section corresponds to transaction LAB-5 of IHE Laboratory Technical Framework. The
actors using this transaction are the Order Filler and the Automation Manager.

8.1 ScopeThis transaction is used when Automation Manager transmits test results to Order Filler.

8.2 Use case roles
Order Filler

Automation
Manager

Test Results Mgt

Actor: Order Filler
Role: The Order Filler manages the test results notified by the Automation Manager.
Actor: Automation Manager
1770

Role: Handles the preprocessing and the analysis processing to fulfill the Work Order,
performs the technical validation and sends the results technically validated to the Order
Filler.

8.3 Referenced standards
HL7 Version 2.5--mainly referred to in Chapter 7.

8.4 Interaction diagrams

Order Filler

Automation
Manager

OUL^ R22, R23 or R24 (Test Result)
ACK^ R22, R23 or R24 (Result Accepted)

Figure 8.4-1: Unsolicited Observation Message from Automation Manager

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8.5 Messages static definitions
1780

8.5.1 Trigger Events
OUL (R22 or R23 or R24) : Automation Manager transmits test results.
The use of R22 is recommended when transferring multiple results related to a specimen
from a patient.
The use of R23 is recommended when transferring multiple results related to one or more
specific containers with one or more specimens from a patient.
The use of R24 is recommended, when transferring multiple results, each one related to none,
one or more specific containers with one or more specimens from a patient.

1790

ACK (R22 or R23 or R24): Order Filler response acknowledgements.
Notes HL7 V2.5 Chapter 7 has no description of ACK message. However, ACK message is necessary to
exchange the messages on the HL7.

8.5.1.1 Message semantics (R22)
Refer to the HL7 standard for the OUL message of HL7 2.5 Chapter 7 and the generalmessage semantics.
Table 8.5-1 OUL^R22
Segment

Meaning

Usage

Card.

HL7
chapter

MSH

Message header

R[1..1]

2[PID]

Patient Identification

RE[0..1]

3[PV1]

Patient VisitO[0..1]

3{--- SPECIMEN beginR[1..*]

SPM

Specimen informationR[1..1]

7[{ OBX }]Observation Result (for Specimen)O[0..*]

7[{0[0..*]

Container informationR[1..1]

13[INV]

Detailed Substance information (e.g.,
ma
nuf
a
c
t
ur
e
r
,… ofQCs
pe
c
i
me
n)

O

[0..1]

13

id,

lot,

}]

--- CONTAINER end{--- ORDER beginR[1..*]

OBR

Observation OrderR[1..1]

7[ORC]

Common OrderO[0..1]

4[{--- RESULT begin

O[0..*]

OBX

Observation ResultR[1..1]7[TCD]

Test Code DetailO[0..1]

13[{SID}]

Substance Identifier (e.g., reagents used for testing)O[0..*]

13[{NTE}]

Notes and commentsO[0..*]}]--- RESULT end}}--- CONTAINER begin
SAC--- ORDER end--- SPECIMEN end

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The carrier information in the case of notifying the test results of a patient's sample uses SAC.
Table 8.5-2 ACK^R22
Segment

Usage

Card.

HL7 chapter

MSH

Message header

MeaningR[1..1]

2

MSA

Message AcknowledgementR[1..1]

2

[ERR]

Error

O

[0..1]

2

1800
Field MSH-9 – Message Type shall have its three components valued as follows:
OUL^R22^OUL_R22
8.5.1.2 Message semantics (R23)
Refer to the HL7 standard for the OUL message of HL7 2.4 or 2.5 Chapter 7 and the generalmessage semantics.
Table 8.5-3: OUL^R23
Segment

Usage

Card.

HL7
chapter

MSH

Message header

R[1..1]

2[PID]

Patient Identification

RE[0..1]

3[PV1]

Patient VisitO[0..1]

3{--- SPECIMEN beginR[1..*]

SPM

Specimen informationR[1..1]

7[{ OBX }]Observation Result (for Specimen)O[0..*]

7{--- CONTAINER beginR[1..*]

SAC

Container informationR[1..1]

13[INV]

Detailed Substance information (e.g., id, lot,
ma
nuf
a
c
t
ur
e
r
,… ofQCs
pe
c
i
me
n)

O

[0..1]

13

{

}
}
}

1810

Meaning--- ORDER beginR[1..*]

OBR

Observation OrderR[1..1]

7[ORC]

Common OrderO[0..1]

4[{--- RESULT begin

O[0..*]

OBX

Observation ResultR[1..1]7[TCD]

Test Code DetailO[0..1]

13[{SID}]

Substance Identifier (e.g., reagents used fortesting)O[0..*]

13[{NTE}]

Notes and commentsO[0..*]}]--- RESULT end--- ORDER end--- CONTAINER end--- SPECIMEN end

Field MSH-9 – Message Type shall have its three components valued as follows:
OUL^R23^OUL_R23

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79

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The carrier information in the case of notifying the test results of a patient's sample uses SAC.
Refer to HL7 Chapter 13 for INV, SID segments and refer to HL7 Chapter 7 for CTI segment.
Table 8.5-4 ACK^R23
Segment

Usage

Card.

HL7 chapter

MSH

Message header

MeaningR[1..1]

2

MSA

Message AcknowledgementR[1..1]

2

[ERR]

Error

O

[0..1]

2

Field MSH-9 - Message Type (MSG) shall have its two first components respectively valued
to "OUL" and "R23".
Note: The message structure of R23 ( SPM { SAC { OBX }} ) seems to be closed to the present use.

8.5.1.3 Message semantics (R24)
1820

Refer to the HL7 standard for the OUL message of HL7 2.5 Chapter 7 and the generalmessage semantics.
Table 8.5-5: OUL^R24
Segment

Meaning

Usage

Card.

HL7
chapter

MSH

Message header

R[1..1]

2[PID]

Patient Identification

RE[0..1]

3[PV1]

Patient VisitO[0..1]

3{--- ORDER beginR[1..*]

OBR

Observation OrderR[1..1]

7[ORC]

Common OrderO[0..1]

4[{TQ1}]

Timing/Quantity

RE[0..1]

4[ {--- SPECIMEN begin

O[0..*]

Specimen informationR[1..1]

7

Observation Result (for Specimen)O[0..*]

7--- CONTAINER begin

O[0..*]

Container informationR[1..1]

13

O[0..1]

13

SPM[{ OBX }]
[{
SAC
[INV]
}]

}

Detailed Substance information
ma
nuf
a
c
t
ur
e
r
,… ofQCs
pe
c
i
me
n)

(e.g.,

id,lot,--- CONTAINER end} ]--- SPECIMEN end[{--- RESULT begin

O[0..*]

OBX

Observation ResultR[1..1]7[TCD]

Test Code DetailO[0..1]

13[{SID}]

Substance Identifier (e.g., reagents used for testing)O[0..*]

13[{NTE}]

Notes and commentsO[0..*]}]--- RESULT end--- ORDER end

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Field MSH-9 – Message Type shall have its three components valued as follows:
OUL^R24^OUL_R24
The carrier information in the case of notifying the test results of a patient's sample uses SAC.
Table 8.5-6: ACK^R24
Segment

1830

Usage

Card.

HL7 chapter

MSH

Message header

MeaningR[1..1]

2

MSA

Message AcknowledgementR[1..1]

2

[ERR]

Error

O

[0..1]

2

Field MSH-9 - Message Type (MSG) shall have its two first components respectively valued
to "OUL" and "R24".
Refer to HL7 Chapter 13 for INV, SID segments and refer to HL7 Chapter 7 for CTI segment.
8.5.1.4 Expected Action
Automation Manager notifies test results with the OUL message to Order Filler. The Order
Filler accepts and registers information, and responds to the Automation Manager with the
ACK message.

8.5.1.5 OBR segment
1840

All fields are optional except those listed in table below.
Table 8.5-7: OBR segment
SEQ

LEN

DT

Usage

Card.

1

4

SI

O

[0..1]

00237

Set ID –OBR

2

22

EI

R

[1..1]

00216

Placer Order Number

3

22

EI

RE

[0..1]

00217

Filler Order Number

4

250

CE

R

[1..1]

00238

Universal Service Identifier

5

2

ID

X

[0..0]

00239

Priority –OBR

6

26

TS

X

[0..0]

00240

Requested Date/Time

7

26

TS

RE

[0..1]

00241

Observation Date/Time #

8

26

TS

RE

[0..1]

00242

Observation End Date/Time #

9

20

CQ

O

[0..1]

00243

Collection Volume *

10

250

XCN

O

[0..*]

00244

Collector Identifier *

11

1

ID

RE

[0..1]

00245

Specimen Action Code *

12

250

CE

X

[0..0]

00246

Danger Code

13

300

ST

X

[0..0]

00247

Relevant Clinical Information

14

26

TS

X

[0..0]

00248

Specimen Received Date/Time *

15

300

SPS

X

[0..0]

00249

Specimen Source

16

250

XCN

R

[1..1]

00226

Ordering Provider

17

250

XTN

RE

[0..2]

00250

Order Callback Phone Number

18

60

ST

X

[0..0]

00251

Placer Field 1

Rev. 1.1–Final Text 08/07/2004

81

TBL#

0065

ITEM#

Element name

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
SEQ

LEN

DT

Usage

Card.

19

60

ST

X

[0..0]

TBL#

00252

Placer Field 2

20

60

ST

X

[0..0]

00253

Filler Field 1 +

21

60

ST

X

[0..0]

00254

Filler Field 2 +

22

26

TS

C

[0..1]

00255

Results Rpt/Status Chng - Date/Time +

23

40

MOC

X

[0..0]

00256

Charge to Practice +

24

10

ID

C

[0..1]

0074

00257

Diagnostic Serv Sect ID

25

1

ID

R

[1..1]

0123

00258

Result Status +

26

400

PRL

O

[0..1]

00259

Parent Result +

27

200

TQ

X

[0..0]

00221

Quantity/Timing

28

250

XCN

O

[0..*]

00260

Result Copies To

29

200

EIP

O

[0..1]

00261

Parent

30

20

ID

X

[0..0]

00262

Transportation Mode

31

250

CE

O

[0..1]

00263

Reason for Study

32

200

NDL

O

[0..1]

00264

Principal Result Interpreter +

33

200

NDL

O

[0..1]

00265

Assistant Result Interpreter +

34

200

NDL

O

[0..1]

00266

Technician +

35

200

NDL

O

[0..1]

00267

Transcriptionist +

36

26

TS

O

[0..1]

00268

Scheduled Date/Time +

37

4

NM

O

[0..1]

01028

Number of Sample Containers *

38

250

CE

O

[0..1]

01029

Transport Logistics of Collected Sample
*

39

250

CE

O

[0..1]

01030

Collector's Comment *

40

250

CE

X

[0..0]

01031

Transport Arrangement Responsibility

41

30

ID

X

[0..0]

0224

01032

Transport Arranged

42

1

ID

X

[0..0]

0225

01033

Escort Required

43

250

CE

X

[0..0]

01034

Planned Patient Transport Comment

44

250

CE

O

[0..1]

0088

00393

Procedure Code

45

250

CWE

O

[0..1]

0340

01316

Procedure Code Modifier

46

250

CE

O

[0..1]

0411

01474

Placer
Supplemental
Information

47

250

CE

O

[0..1]

0411

01475

Filler Supplemental Service Information

48

250

CWE

X

[0..0]

0476

01646

Medically
Necessary
Procedure Reason.

49

2

IS

O

[0..1]

0507

01647

Result Handling

0124

ITEM#

Element nameAll field data should reflect LAB-4t
r
a
ns
a
c
t
i
on’
sOBR.
8.5.1.6 TCD segment
All fields are optional except those listed in table below.
Table 8.5-8 : TCD segment
SEQ

LEN

DT

Usage

Card.

1

250

CE

R

[1..1]

Rev. 1.1–Final Text 08/07/2004

82

TBL#

ITEM#

Element name00238

Universal Service Identifier

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHIS

Service

DuplicateIHE Laboratory Technical Framework, vol. 2: Transactions

9 Real world use cases
9.1 Guidelines
1850

Each of the real world use cases in this section are to be considered as a template for handlinga category of laboratory testing throughout all the transactions of the Laboratory Technical
Framework. Only the major steps and interactions are described.
Each use case is described by a storyboard that describes the complete workflow inchronological order, completed by an interaction diagram, and illustrated by the mostsignificant messages of this workflow.
The message descriptions are abbreviated, to focus on the main points of interest.
For brevity, only some of the application acknowledgements are shown.
The a
c
t
or
s
’na
me
sa
r
ea
bbr
e
v
i
a
t
e
d wi
t
ht
he
i
ri
ni
t
i
a
l
s(
OP,OF,AM,ORT).The
se
abbreviations are also used in the MSH-3 (sending application) and MSH-5 (receiving
application) fields.

1860

All use cases assume that the placer order is related to a placer group number (ORC-4).
All tests are identified in OBX segments by their LOINC code when available.
Colors point out key information in the messages.

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9.2 Two Hematology batteries on a blood specimen
9.2.1 Storyboard
This example corresponds to the us
ec
a
s
ede
s
c
r
i
be
di
nVol
ume1a
s“
Externally placed order
wi
t
hs
p
e
c
i
me
nsuni
de
nt
i
f
i
e
dort
obec
ol
l
e
c
t
e
dbyt
hel
a
bor
a
t
or
y
”
.Thes
pe
c
i
me
ni
snot
identified by the ordering care unit.
Dr Physician orders two batteries of tests on the same specimen: blood count and differential
blood count.
1870

Human actors and organizations participating to the process:

1880

Assigning authority: Abbeville Hospital
Placer:
Urology department.
Filler:
Cytology laboratory.
Ordering facility:
Urology.
Patient:
John Ill, Patient hospital identifier: 6543210, Patient visit number:
999888, class = inpatient
Orderer:Dr Uro.
Placer order enterer: Janet Nurse.
Specimen collector: John Collect.
Technician:Marc Techos.
Clinical expert:

Jane Cyto.

ID numbers used by the workflow:
ID number
Patient hospital ID
Patient visit number
Care unit order group
Care unit order (1st battery)Care unit order (2nd battery)Laboratory order (1st battery)idem for work order
Laboratory order (2nd battery)idem for work orderSpecimenValue
65432109998888555
98765439876544
456

Assigned by
Admission office (ADT)
Admission office (ADT)
Urology department (OP)
Urology department (OP)
Urology department (OP)
Cytology laboratory (OF)457

Cytology laboratory (OF)456_1

Cytology laboratory (OF)LAB-1 interaction: The Care Unit collects a specimen related to an order for a blood countand a differential count, and sends the specimen to the chemistry laboratory. The Order
Pl
a
c
e
rs
e
ndsame
s
s
a
g
e“
ne
wor
de
r
”(
NW)a
c
c
ompa
ny
i
ngt
hes
pe
c
i
me
n,t
ol
e
t the laboratory
start the testing.

1890

LAB-4, LAB-1 and LAB-3 interactions: The laboratory checks the specimen and schedules
the work. An identifier is assigned to the specimen by the Order Filler and the corresponding
identification label is printed out. The Order Filler sends a unique work order to the
Automation Manager. The Order Filler notifies both Order Placer and Order Result Trackerof the scheduled work.

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LAB-5, LAB-1 and LAB-3 interactions: After technical validation by a laboratory
technician (Marc Techos), the Automation Manager sends back all the observations to theOrder Filler.
LAB-1 and LAB-3 interactions: After clinical validation, the Order Filler notifies the results
to the Order Result Tracker, and notifies the status change to the Order Placer.
9.2.2 Interaction diagram
Order Placer

Order Filler

Autom ation
Manager

Order R esult
Tracker

Order enteredspecim ensent tolaboratory

OML^O33 (NW)
9.2.3.1
ORL^O34
9.2.3.1

Specimens checked.
Order started

OML^O33 (SC)9.2.3.3

OML^O21 (NW)
9.2.3.2
ACK^R229.2.3.4
OUL^R22 (SC)9.2.3.5

OUL^R22 (SC)9.2.3.4
technical
validation

Clinical validation
OML^O33 (SC)9.2.3.6

1900

OUL^R22 (SC)9.2.3.7

9.2.3 Messages
9.2.3.1 LAB-1 (OP  OF):Message“New or
der
”wi
t
honespecimen
A new placer order sent to the Order Filler:

1910

MSH|^~\&|OP|Urology|OF|Cytology|200310060820||OML^O33^OML_O33|001|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
SPM|1|||BLD|||||||P||||||200310060735|||||||||1
ORC|NW|9876543^Urology||555^Urology|||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|9876543^Urology||85027^Hemogram and platelet count, automated^CPT4||||||^COLLECT^JOHN||||||^URO^^^^DR
ORC|NW|9876544^Urology||555^Urology|||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|9876544^Urology||85009^Differential WBC Count, buffy coat^CPT4||||||^COLLECT^JOHN||||||^URO^^^^DR

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.

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9.2.3.2 LAB-4 (OF  AM):Message“New order”A new work order is sent to the Automation Manager:
1920

1930

MSH|^~\&|OF|Cytology|AM|Automation|200310060825||OML^O33^OML_O33|101|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||||||||1
ORC|NW|||555^Urology|||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|456^Cytology||85027^Hemogram and platelet count, automated^CPT4||||||^COLLECT^JOHN||||||^URO^^^^DR
ORC|NW|||555^Urology|||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|457^Cytology||85009^Differential WBC Count, buffy coat^CPT4||||||^COLLECT^JOHN||||||^URO^^^^DR

Acknowledgement sent by the Automation Manager:

1940

1950

MSH|^~\&|AM|Automation|OF|Cytology|200310060826||ORL^O34^ORL_O34|301|T|2.5|||||USA|
EN
MSA|AA|101
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||||||||1
ORC|OK|||555^Urology|SC||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|456^Cytology||85027^Hemogram and platelet count, automated^CPT4||||||^COLLECT^JOHN|S|||||^URO^^^^DR
ORC|OK|||555^Urology|SC||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|457^Cytology||85009^Differential WBC Count, buffy coat^CPT4||||||^COLLECT^JOHN|S|||||^URO^^^^DR

9.2.3.3 LAB-1 (OF  OP):Message“Statuschanged”
The placer order has been assigned a filler order number, the specimen is available andidentified by the laboratory:

1960

1970

MSH|^~\&|OF|Cytology|OP|Urology|200310060825||OML^O33^OML_O33|108|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||Y||||||1
ORC|SC|9876543^Urology||555^Urology|IP||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|9876543^Urology|456^Cytology|85027^Hemogram and platelet count,automated^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||||I
ORC|SC|9876544^Urology||555^Urology|IP||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|9876544^Urology|457^Cytology|85009^Differential WBC Count, buffy coat^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||||I

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.2.3.4 LAB-3 (OF->ORT):Message“New Or
der”Rev. 1.1–Final Text 08/07/2004

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The Order Result Tracker is notified of the creation of the filler order by means of a
result message:

1980

1990

MSH|^~\&|OF|Cytology|ORT||200310060825||OUL^R22^OUL_R22|122|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||Y||||||1
OBR|1|9876543^Urology|456^Cytology|85027^Hemogram and platelet count,automated^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||||I
ORC|SC|9876543^Urology||555^Urology|IP||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|2|9876544^Urology|457^Cytology|85009^Differential WBC Count, buffy coat^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||||I
ORC|SC|9876544^Urology||555^Urology|IP||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R

Acknowledgement sent by the Order Results Tracker:
MSH|^~\&|ORT||OF|Cytology|200310060826||ACK^R22^ACK_R22|401|T|2.5|||||USA|EN
MSA|AA|122

9.2.3.5 LAB-5 (AM->OF): Message“New Results”
The Automation Manager sends the final results for the work order:
2000

2010

2020

MSH|^~\&|AM|Automation|OF|Urology|200310060900||OUL^R22^OUL_R22|308|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||Y||||||1
OBR|1|456^Cytology||85027^Hemogram and platelet count, automated^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||200310060832|||F|||||||&TECHOS&MARC^200310060833
ORC|SC||||CM||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^^UR01
OBX|1|NM|11156-7^LEUKOCYTES^LN||8.2|10*3/mm3|4-10|N|||F|||200310060830
OBX|2|NM|11273-0^ERYTHROCYTES^LN||4.08|10*6/mm3|10-12|N|||F|||200310060830
OBX|3|NM|20509-6^HEMOGLOBIN^LN||13.4|g/dL|11.5-14.5|N|||F|||200310060830
OBX|4|NM|20570-8^HEMATOCRIT^LN||39.7|%|37-47|N|||F|||200310060830
OBX|5|NM|30428-7^MCV^LN||97|fL|80-95|N|||F|||200310060830
OBX|6|NM|28539-5^MCH^LN||33.0|pg|27-32|N|||F|||200310060830
OBX|7|NM|28540-3^MCHC^LN||33.8|%|30-36|N|||F|||200310060830
OBX|8|NM|11125-2^PLATELETS^LN||220|10*9/L|150-400|N|||F|||200310060830
OBR|2|457^Cytology||85009^Differential WBC Count, buffy coat^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR||||||200310060832|||F|||||||&TECHOS&MARC^200310060833
ORC|SC||||CM||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^^UR01
OBX|1|NM|23761-0^NEUTROPHILS/100 LEUKOCYTES^LN||72|%||N|||F|||200310060830
OBX|2|NM|26450-7^EOSINOPHILS/100 LEUKOCYTES^LN||2|%||N|||F|||200310060830
OBX|3|NM|26478-8^LYMPHOCYTES/100 LEUKOCYTES^LN||20|%||N|||F|||200310060830
OBX|4|NM|26485-3^MONOCYTES/100 LEUKOCYTES^LN||6|%||N|||F|||200310060830
OBX|5|NM|30180-4^BASOPHILS/100 LEUKOCYTES^LN||0|%||N|||F|||200310060830

The related acknowledgement message isn’tshown.
9.2.3.6 LAB-1 (OF->OP):Message“StatusChanged”
2030

The clinical expert has performed the clinical validation at 09h29. The order iscompleted:
MSH|^~\&|OF|Urology| OP|Urology|200310060930||OML^O33^OML_O33|181|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M

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PV1|1|I||||||||||||||||9998888
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||Y||||||1
ORC|SC|9876543^Urology||555^Urology|CM||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|9876543^Urology|456^Cytology|85027^Hemogram and platelet count,automated^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||||F|||||||&CYTO&JANE^200310060929
ORC|SC|9876544^Urology||555^Urology|CM||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBR|1|9876544^Urology|457^Cytology|85009^Differential WBC Count, buffy coat^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||||F|||||||&CYTO&JANE^200310060929

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.2.3.7 LAB-3 (OF->ORT):Message“StatusChanged”
2050

2060

2070

2080

The clinical expert has performed the clinical validation at 09h29. The order iscompleted. The results are final:
MSH|^~\&|OF|Cytology|ORT||200310060931||OUL^R22^OUL_R22|182|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||Y||||||1
OBR|1|9876543^Urology|456^Cytology|85027^Hemogram and platelet count,automated^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||200310060929|||F|||||||&CYTO&JANE^200310060929
ORC|SC|9876543^Urology||555^Urology|CM||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBX|1|NM|11156-7^LEUKOCYTES^LN||8.2|10*3/mm3|4-10|N|||F|||200310060830
OBX|2|NM|11273-0^ERYTHROCYTES^LN||4.08|10*6/mm3|10-12|N|||F|||200310060830
OBX|3|NM|20509-6^HEMOGLOBIN^LN||13.4|g/dL|11.5-14.5|N|||F|||200310060830
OBX|4|NM|20570-8^HEMATOCRIT^LN||39.7|%|37-47|N|||F|||200310060830
OBX|5|NM|30428-7^MCV^LN||97|fL|80-95|N|||F|||200310060830
OBX|6|NM|28539-5^MCH^LN||33.0|pg|27-32|N|||F|||200310060830
OBX|7|NM|28540-3^MCHC^LN||33.8|%|30-36|N|||F|||200310060830
OBX|8|NM|11125-2^PLATELETS^LN||220|10*9/L|150-400|N|||F|||200310060830
OBR|2|9876544^Urology|457^Cytology|85009^Differential WBC Count, buffy coat^CPT4||||||^COLLECT^JOHN|P|||||^URO^^^^DR|||||||200310060929|||F|||||||&CYTO&JANE^200310060929
ORC|SC|9876544^Urology||555^Urology|CM||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^^UR01
TQ1|1||||||||R
OBX|1|NM|23761-0^NEUTROPHILS/100 LEUKOCYTES^LN||72|%||N|||F|||200310060830
OBX|2|NM|26450-7^EOSINOPHILS/100 LEUKOCYTES^LN||2|%||N|||F|||200310060830
OBX|3|NM|26478-8^LYMPHOCYTES/100 LEUKOCYTES^LN||20|%||N|||F|||200310060830
OBX|4|NM|26485-3^MONOCYTES/100 LEUKOCYTES^LN||6|%||N|||F|||200310060830
OBX|5|NM|30180-4^BASOPHILS/100 LEUKOCYTES^LN||0|%||N|||F|||200310060830

The related acknowledgement me
s
s
a
gei
s
n’
ts
hown.

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88

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9.3 Test on a series of specimens: Glucose tolerance study
9.3.1 Storyboard
This use case is in the context given by the first general use case presented in Volume 1
“
3.
1.
1:Ext
e
r
na
l
l
ypl
a
c
e
dor
de
rwi
t
hi
de
nt
i
f
i
e
ds
pe
c
i
me
ns
”
.Theor
de
r
i
ngc
a
r
eunit thus
identifies the specimens.
2090

Dr Physician orders one battery and provides a series of specimen collected at different times.
The battery consists of one single test: glucose concentration on blood serum, repeated on anumber of specimens, to be performed by the chemistry laboratory. The order is assumed to
bepa
r
tofag
r
oupofpl
a
c
e
ror
de
r
si
de
nt
i
f
i
e
dbyt
hepl
a
c
e
rg
r
oupnumber‘
666’.
Glucose tolerance is ordered as a single battery requesting for glucose test on an unspecified
number of blood serum dr
a
wna
tdi
f
f
e
r
e
nti
nt
e
r
va
l
s
,a
f
t
e
ri
ni
t
i
a
lg
l
uc
os
ei
nge
s
t
i
on”
.TheSPMsegments in the order message indicate the number of specimens, which can vary. The result
consists of all the observation performed on each related individual specimen. All specimens
produce results, except one unfortunately broken.
Human actors and organizations participating to the process:

2100

2110

Assigning authority: Memphis Hosp.
Placer:Entero-gastric department.
Filler:Chemistry laboratory.
Ordering facility:
Entero-gastric.
Patient:
Adam Everyman Jr, account number: 12345 (check-digit 5 modulo 10),class = outpatient.
Orderer:
Dr Physician, phone number 821, ID number in the hospital 222222.
Placer order enterer: Nancy Nurse, ID number 222221.
Specimen collector: M. Bleeder, ID number 1234.
Technician:Suzy Technician, ID number 333333.
Clinical expert:
Jane Chemistry-Expert, ID number 444444.
ID numbers used by the workflow:
ID number
Patient ID
Care unit order
Care unit order group
1st specimen
2nd specimen
3rd specimen
4th specimen
5th specimen
Laboratory order
1st work order
2nd work order
3rd work order
4th work order

Rev. 1.1–Final Text 08/07/2004

89

Value
12345
12345678
666
123456781
123456782
123456783
123456784
123456785
555
555_1
555_2
555_3
555_4

Assigned by
Admission office (ADT)Entero-gastric department (OP)Entero-gastric department (OP)Entero-gastric department (OP)Entero-gastric department (OP)Entero-gastric department (OP)Entero-gastric department (OP)Entero-gastric department (OP)Chemistry laboratory (OF)
Chemistry laboratory (OF)
Chemistry laboratory (OF)
Chemistry laboratory (OF)
Chemistry laboratory (OF)Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
LAB-1 interaction: The Care Unit collects the first three specimens related to an order for
g
l
uc
os
et
ol
e
r
a
nc
e
,wi
t
ht
hehi
g
hpr
i
or
i
t
y‘
ASAP’
,a
nds
e
nds these specimens to the chemistry
l
a
bor
a
t
o
r
y
.TheOr
de
rPl
a
c
e
rs
e
ndsame
s
s
a
g
e“
ne
wor
de
r
”(
NW)a
c
c
ompa
ny
i
ngt
hef
i
r
s
t
three specimens, to let the laboratory start the testing. OBR-11“
Spe
c
i
me
na
c
t
i
onc
ode
”i
s
va
l
ue
dt
o“
P”(
pe
ndi
ngs
pe
c
i
me
n)i
ndi
c
a
t
i
ngthat some specimens for this order are still
pending (i.e. not yet collected). The order placer provides an observation reporting the initialquantity of sugar absorbed by the patient.
2120

LAB-4, LAB-1 and LAB-3 interactions: The laboratory checks the specimens andschedules the work. The Order Filler sends the first work orders to the Automation Manager.
The Order Filler notifies both Order Placer and Order Result Tracker of the scheduled work,
not
i
f
y
i
ngt
ha
tt
het
hi
r
ds
pe
c
i
me
nb
e
i
ngbr
oke
n,won’
tpr
oducea
nyobservation. SPM-20
(
s
pe
c
i
me
na
va
i
l
a
bi
l
i
t
y
)=‘
N’a
ndSPM-21(
s
pe
c
i
me
nr
e
j
e
c
tr
e
a
s
on)=‘
RB’(
br
oke
n
c
ont
a
i
ne
r
)
.Si
nc
et
hi
si
sat
i
mi
ngs
e
r
i
e
s
,t
heOr
de
rPl
a
c
e
rwon’
tr
e
pl
a
c
et
hi
ss
pe
c
i
me
n.The
r
e
will simply be a missing point in the final observation graph.
LAB-5, LAB-1 and LAB-3 interactions: After technical validation by , the Automation
Manager sends back the first two observations to the Order Filler. Given that the order
pr
i
or
i
t
yi
s“
ASAP”
,t
heOr
de
rFi
l
l
e
rnot
i
f
i
e
st
he
s
epa
r
t
i
a
lr
e
s
ul
tt
ot
heOr
de
rResult Tracker,
and notifies the status change to the Order Placer, without waiting for the clinical validation.

2130

LAB-1 interaction: Later on, as the two last specimens are sent to the laboratory, the Order
Placer sends an additional message for that order, wi
t
ht
heor
de
rc
ont
r
ol“
c
ha
ngeor
de
r
r
e
que
s
t
”(
XO)
.Thi
sme
s
s
a
gec
ont
a
i
nst
hec
ompl
e
t
el
i
s
tofs
pe
c
i
me
ns
.OBR-11“
Spe
c
i
me
n
a
c
t
i
onc
ode
”i
sva
l
ue
dt
o“
S”
,i
ndi
c
a
t
i
ngt
ha
tt
hes
pe
c
i
me
nc
ol
l
e
c
t
i
oni
sc
ompl
e
t
e
,a
ndt
ha
tt
he
laboratory can achieve its work.
LAB-4, LAB-1 and LAB-3 interactions: The laboratory checks the last specimens. The
Order Filler sends the last work orders to the Automation Manager. The Order Filler notifies
both Order Placer and Order Result Tracker with the progress of the order.
LAB-5 interaction: After technical validation, the Automation Manager sends the last results
to the Order Filler.

2140

LAB-1 and LAB-3 interactions: After clinical validation, the Order Filler notifies the final
results to the Order Result Tracker, and notifies the status change to the Order Placer.

Rev. 1.1–Final Text 08/07/2004

90

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

9.3.2 Interaction diagram

Order Placer

Order Filler

Automation
Manager

Order Result
Tracker

Order enteredFirst 3
specimens
sent tolaboratory

OML^O21 (NW)
9.3.3.1

Specimens checked.
Order started
OML^O21 (NW)
9.3.3.2

OML^O21 (SC)9.3.3.3

OUL^R21 (SC)9.3.3.5

OML^O21 (SC)9.3.3.6
Last 2
specimens
sent tolaboratory

OML^O21 (XO)
9.3.3.8

OUL^R24 (NW)
9.3.3.4
first technicalvalidation
OUL^R24 (SC)9.3.3.7

Last specimens checked.
OML^O21 (NW)
9.3.3.9

OML^O21 (SC)9.3.3.10

OUL^R21 (SC)9.3.3.12

OUL^R24 (SC)9.3.3.11
last technical validation

Clinical validation
OML^O21 (SC)9.3.3.13

OUL^R24 (SC)9.3.3.14

9.3.3 Messages
9.3.3.1 LAB-1 (OP  OF):Message“New or
der
”wi
t
ht
hef
i
r
st3speci
mens

2150

2160

A ne
w pl
a
c
e
ror
de
rs
e
ntt
ot
heOr
de
rFi
l
l
e
r
:Pr
i
or
i
t
y“
ASAP”f
ort
hi
spl
a
c
e
ror
de
r
.One
observation provided by the placer. Three first specimens collected. The other specimens are
pending.
MSH|^~\&|OP|Entero-gastric|OF|Chemistry|200309060820||OML^O21^OML_O21|
msgOP123|T|2.5|123| |||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|NW|12345678^gastric||666^gastric|||||200309060710|222221^NURSE^NANCY|||||||||||
Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||12345678^gastric||82951^Glucose Tolerance Test^CPT4||||||1234^BLEEDER|
P|||||222222^PHYSICIAN^^^^DR|821
OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735
SPM|1|123456781^gastric||SER|||||||P||||||200309060735|||||||||1
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|||||||||1
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|||||||||1

Rev. 1.1–Final Text 08/07/2004

91

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.2 LAB-4 (OF  AM):Message“New or
der
”wi
t
ht
hef
i
r
st2speci
mens
2170

2180

Two new work orders sent to the Automation Manager: Priority ASAP. One observation
provided.
MSH|^~\&|OF|Chemistry|AM|Automation|200309060825||OML^O21^OML_O21|msgOF101|T|2.5|12
3||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|NW|||666^gastric|||||200309060824|222221^NURSE^NANCY|||||||||||
Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||555_1^chemistry||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||222222^PHYSICIAN^^^^DR|821
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||||||||1
ORC|NW|||666^gastric|||||200309060710|222221^NURSE^NANCY|||||||||||
Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||555_2^chemistry||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||
222222^PHYSICIAN^^^^DR|821
SPM|1|123456782^gastric||SER|||||||P||||||200309060755|200309060821||||||||1

The related acknowledgeme
ntme
s
s
a
gei
s
n’
ts
hown.
2190

9.3.3.3 LAB-1 (OF  OP):Message“Statuschanged”wi
t
ht
hef
i
r
st3
specimens
The placer order has been assigned a filler order number. One specimen is rejected:

2200

MSH|^~\&|OF|Chemistry|OP|Entero-gastric|200309060825||OML^O21^OML_O21|msgOF102|
T|2.5|123| |||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|SC|12345678^gastric||666^gastric |IP||||200309060824|222221^NURSE^NANCY||||||||||| Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance Test^CPT4||||||
1234^BLEEDER|P|||||222222^PHYSICIAN^^^^DR|821||||||||I
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|200309060821||Y||||||1
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.4 LAB-3 (OF  ORT)
:Message“New or
der
”wi
t
ht
hef
i
r
st3specimens
2210

The Order Result Tracker is notified with the creation of the filler order: One
observation is canceled.
MSH|^~\&|OF|Chemistry|ORT||200309060825||OUL^R24^OUL_R24|msgOF103|T|2.5|123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance Test^CPT4||||||
1234^BLEEDER|P|||||222222^PHYSICIAN^^^^DR|821||||||||I
ORC|SC|12345678^gastric||666^gastric |IP||||200309060824|222221^NURSE^NANCY|||||||||||Entero-gastric^^^^^^FI^^^EG02

Rev. 1.1–Final Text 08/07/2004

92

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

2220

TQ1|||||||||A
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|200309060821||Y||||||1
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1
OBX|1|NM|30264-6^GLUCOSE 40M POST DOSE GLUCOSE^LN||||||||X
OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.5 LAB-5 (AM OF)
:Message“New r
esul
t
s”f
ort
hef
i
r
st2workor
ders
The Automation Manager sends the two final results for the 2 work orders, technicallyvalidated by Suzy TECHNICIAN at 8h33:
2230

2240

MSH|^~\&|AM|Automation|OF|Chemistry|200309060833||OUL^R24^OUL_R24|msgAM1|T|2.5|123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
OBR||555_1^chemistry||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||222222^PHYSICIAN^^^^DR|821||||||200309060832|||F|||||||333333&TECHNICIAN&Suz
y^200309060833
OBX|1|NM|14749-6^GLUCOSE^LN||4200|umol/l||N|||F|||200309060830
OBR||555_2^chemistry||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||222222^PHYSICIAN^^^^DR|821||||||200309060832|||F|||||||333333&TECHNICIAN&Suz
y^200309060833
OBX|1|NM|14749-6^GLUCOSE^LN||6000|umol/l||N|||F|||200309060832

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.6 LAB-1 (OF  OP):Message“Statuschanged”
Some results are available, not clinically validated (i.e. not verified)

2250

2260

MSH|^~\&|OF|Chemistry|OP|Entero-gastric|200309060834||OML^O21^OML_O21|msgOF104|
T|2.5|123| |||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|SC|12345678^gastric||666^gastric|A||||200309060834|222221^NURSE^NANCY|||||||||||Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance
Test^CPT4||||||1234^BLEEDER|P|||||222222^PHYSICIAN^^^^DR|821||||||||R
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|200309060821||Y||||||1
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.7 LAB-3 (OF  ORT)
:Message“Statuschanged”
The two first results are sent, not clinically validated (i.e. not verified):2270

MSH|^~\&|OF|Chemistry|ORT||200309060825||OUL^R24^OUL_R24|msgOF105|T|2.5|123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
OBR||12345678^gastric|^chemistry|82951^Glucose Tolerance
Test^CPT4||||||1234^BLEEDER|P|||||222222^PHYSICIAN^^^^DR|821||||||||R
ORC|SC|12345678^gastric||666^gastric|A||||200309060834|222221^NURSE^NANCY|||||||||||Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
OBX|1|NM|14996-3^GLUCOSE PRE 75 G GLUCOSE PO^LN||4200|umol/l|4000-6100|N|||

Rev. 1.1–Final Text 08/07/2004

93

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions2280

R|||200309060830
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|200309060821||Y||||||1
OBX|1|NM|30263-8^GLUCOSE 20M POST DOSE GLUCOSE^LN||6000|umol/l|<7800|N|||
R|||200309060832
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1
OBX|1|NM|30264-6^GLUCOSE 40M POST DOSE GLUCOSE^LN|| | |||||X
OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.8 LAB-1(OP  OF): Message “Changeor
der
/
ser
vi
cer
equest”
The last 2 specimens have been collected and are sent to the laboratory:

2290

2300

MSH|^~\&|OP|Entero-gastric|OF|Chemistry|200309060900||OML^O21^OML_O21|msgOP124|
T|2.5|123| |||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|XO|12345678^gastric||666^gastric|||||200309060855|222221^NURSE^NANCY|||||||||||Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||12345678^gastric||82951^Glucose Tolerance Test^CPT4||||||1234^BLEEDER|S|||||
222222^PHYSICIAN^^^^DR|821
OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|||||||||1
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|||||||||1
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|||||||||1
SPM|4|123456784^gastric ||SER|||||||P||||||200309060835|||||||||1
SPM|5|123456785^gastric ||SER|||||||P||||||200309060855|||||||||1

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.9 LAB-4 (OF  AM):Message“New or
der
”wi
t
ht
he last 2 specimens
Two new work orders sent to the Automation Manager:

2310

2320

MSH|^~\&|OF|Chemistry|AM|Automation|200309060905||OML^O21^OML_O21|msgOF106|T|2.5|12
3| |||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|NW|||666^gastric|||||200309060904|222221^NURSE^NANCY|||||||||||
Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||555_4^chemistry ||GLUC^GLUCOSE^L||||||1234^BLEEDER|
S|||||222222^PHYSICIAN^^^^DR|821
SPM|1|123456784^gastric ||SER|||||||P||||||200309060835|200309060902||||||||1
ORC|NW|||666^gastric|||||200309060904|222221^NURSE^NANCY|||||||||||
Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||555_5^chemistry ||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||
222222^PHYSICIAN^^^^DR|821
SPM|1|123456785^gastric ||SER|||||||P||||||200309060855|200309060902||||||||1

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.10 LAB-1 (OF  OP):Message“Statuschanged”withal
lspecimens
All the specimens have been checked by the laboratory staff.
MSH|^~\&|OF|Chemistry|OP|Entero-gastric|200309060905||OML^O21^OML_O21|msgOF107|
T|2.5|123| |||USA||EN

Rev. 1.1–Final Text 08/07/2004

94

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

2330

2340

PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|SC|12345678^gastric||666^gastric|A||||200309060904|222221^NURSE^NANCY|||||||||||Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance test^CPT4||||||
1234^BLEEDER|P|||||222222^PHYSICIAN^^^^DR|821||||||||R
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|200309060821||Y||||||1
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1
SPM|4|123456784^gastric ||SER|||||||P||||||200309060835|200309060902||Y||||||1
SPM|5|123456785^gastric ||SER|||||||P||||||200309060855|200309060902||Y||||||1

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.11 LAB-3 (OF  ORT)
:Message“Statuschanged”
The last two specimens have been received. All the work is scheduled:

2350

2360

MSH|^~\&|OF|Chemistry|ORT||200309060905||OUL^R24^OUL_R24|msgOF108|T|2.5|123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance Test^CPT4||||||
1234^BLEEDER|S|||||222222^PHYSICIAN^^^^DR|821||||||||R
ORC|SC|12345678^gastric||666^gastric|A||||200309060904|222221^NURSE^NANCY|||||||||||Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
OBX|1|NM|14996-3^GLUCOSE PRE 75 G GLUCOSE PO^LN||4200|umol/l|4000-6100|N|||
R|||200309060830
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|200309060821||Y||||||1
OBX|1|NM|30263-8^GLUCOSE 20M POST DOSE GLUCOSE^LN||6000|umol/l|<7800|N|||
R|||200309060832
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1
OBX|1|NM|30264-6^GLUCOSE 40M POST DOSE GLUCOSE^LN|| | |||||X
SPM|4|123456784^gastric ||SER|||||||P||||||200309060835|200309060902||Y||||||1
SPM|5|123456785^gastric ||SER|||||||P||||||200309060855|200309060902||Y||||||1
OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.3.3.12 LAB-5 (AM OF)
:Message“New r
esul
t
s”f
ort
hel
ast2wor
kor
der
s
2370

2380

The Automation Manager sends the two final results for the 2 work orders, technicallyvalidated by Suzy TECHNICIAN at 9h12.
MSH|^~\&|AM|Automation|OF|Chemistry |200309060912||OUL^R24^OUL_R24|msgAM2|
T|2.5|123||||USA ||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
OBR||555_4^chemistry||30266-1^GLUCOSE 1.6H POST DOSE GLUCOSE^LN||||||1234^BLEEDER|
S|||||222222^PHYSICIAN^^^^DR|821||||||200309060911|||F|||||||
333333&TECHNICIAN&Suzy^200309060912
OBX|1|NM|14749-6^GLUCOSE^LN||7200|umol/l||N|||F|||200309060910
OBR||555_5^chemistry ||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||
222222^PHYSICIAN^^^^DR|821||||||200309060911|||F|||||||333333&TECHNICIAN&Suzy^20030
9060912
OBX|1|NM|14749-6^GLUCOSE^LN||7100|umol/l||N|||F|||200309060911

The related acknowl
e
dg
e
me
ntme
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s
a
gei
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9.3.3.13 LAB-1 (OF  OP):Message“Statuschanged”
2390

2400

Jane CHEMISTRY-EXPERT has performed the clinical validation at 9h29. The orderis completed.
MSH|^~\&|OF|Chemistry|OP|Entero-gastric|200309060930||OML^O21^OML_O21|msgOF109|
T|2.5|123||| |USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|SC|12345678^gastric||666^gastric|CM||||200309060929|222221^NURSE^NANCY|||||||||||Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance Test^CPT4||||||
1234^BLEEDER|S|||||222222^PHYSICIAN^^^^DR|821||||||200309060929|||F|||||||
444444&CHEMISTRY-EXPERT&Jane^200309060929
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|200309060821||Y||||||1
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1
SPM|4|123456784^gastric ||SER|||||||P||||||200309060835|200309060902||Y||||||1
SPM|5|123456785^gastric ||SER|||||||P||||||200309060855|200309060902||Y||||||1

Ther
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l
a
t
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da
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dg
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s
s
a
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ts
hown.
9.3.3.14 LAB-3 (OF  ORT)
:Message“Statuschanged”
2410

2420

2430

Jane CHEMISTRY-EXPERT has performed the clinical validation at 9h29. The orderis completed. The results are final.
MSH|^~\&|OF|Chemistry|ORT||200309060930||OUL^R24^OUL_R24|msgOF110|T|2.5|123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance Test^CPT4||||||
1234^BLEEDER|S|||| |222222^PHYSICIAN^^^^DR|821||||||A|200309060929|||F|||||||
444444&CHEMISTRY-EXPERT&Jane^200309060929
ORC|SC|12345678^gastric||666^gastric|CM||||200309060929|222221^NURSE^NANCY|||||||||||Entero-gastric^^^^^^FI^^^EG02
TQ1|||||||||A
SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
OBX|1|NM|14996-3^GLUCOSE PRE 75 G GLUCOSE PO^LN||4200|umol/l|4000-6100|N|||
F|||200309060830
SPM|2|123456782^gastric ||SER|||||||P||||||200309060755|200309060821||Y||||||1
OBX|1|NM|30263-8^GLUCOSE 20M POST DOSE GLUCOSE^LN||6000|umol/l|<7800|N|||
F|||200309060832
SPM|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1
OBX|1|NM|30264-6^GLUCOSE 40M POST DOSE GLUCOSE^LN||||||||X
SPM|4|123456784^gastric ||SER|||||||P||||||200309060835|200309060902||Y||||||1
OBX|1|NM|14756-1^GLUCOSE 1H POST DOSE GLUCOSE^LN||7200|umol/l|<7800|N|||
F|||200309060910
SPM|5|123456785^gastric ||SER|||||||P||||||200309060855|200309060902||Y||||||1
OBX|1|NM|30265-3^GLUCOSE 1.3H POST DOSE GLUCOSE^LN||7100|umol/l|<7800|N|||
F|||200309060911
OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735

Ther
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9.4 Battery with 2 specimens: Creatinine clearance
9.4.1 Storyboard
Thi
se
xa
mpl
ec
or
r
e
s
pondst
ot
heus
ec
a
s
ede
s
c
r
i
be
di
nVol
ume1a
s“
Externally placed order
wi
t
hs
pe
c
i
me
nsuni
de
nt
i
f
i
e
dort
obec
ol
l
e
c
t
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dbyt
hel
a
bor
a
t
or
y
”
.Thes
pe
c
i
me
nsa
r
enot
identified by the ordering care unit.
Dr Nephro orders one battery of one test: a creatinine clearance.

2450

The battery consists of a procedure applied on two specimen type, serum and 24 hour urine.
At the end of the 24 hour urine collection process, the specimen collector mesures thecollected urine volume, records the duration of collection, takes a urine sample from the 24hours collection and draws a serum sample from the patient.
The order is assumed to be part of a group of placer orders identified by the placer group
numbe
r‘
777’
.
Human actors and organizations participating to the process:

2460

Assigning authority: Abbeville Hospital
Placer:Nephrology department.
Filler:Chemistry laboratory.
Ordering facility:
Nephrology.
Patient:
John Ill, Patient hospital identifier: 6543210, Patient visit number:
999888, class = inpatient
Orderer:
Dr Nephro.
Placer order enterer: Janet Nurse.
Specimen collector: John Collect.
Technician:Marc Techos.
Clinical expert:

Jane Chemistry.

ID numbers used by the workflow:
ID number

Value

Assigned by

Patient hospital ID

6543210

Admission office (ADT)Patient visit number

9998888

Admission office (ADT)

Care unit order group

777

Nephrology department (OP)

Care unit order

9876543

Nephrology department (OP)Laboratory order (1st battery)idem for work order654

Chemistry laboratory (OF)Specimen Serum

654_1

Chemistry laboratory (OF)Specimen Urine

654_2

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2470

LAB-1 interaction: The Care Unit processes the specimen collection related to an order for acreatinine clearance, and sends the notified or measured values and the specimens to the
c
he
mi
s
t
r
yl
a
bor
a
t
or
y
.TheOr
de
rPl
a
c
e
rs
e
ndsame
s
s
a
g
e“
ne
wor
de
r
”(
NW)a
c
c
ompa
ny
i
ng
the specimen, to let the laboratory start the testing.
LAB-4, LAB-1 and LAB-3 interactions: The laboratory checks the specimens andschedules the work. An identifier is assigned to the specimens by the Order Filler and thecorresponding identification labels are printed out. The Order Filler sends a unique workorder to the Automation Manager. The Order Filler notifies both Order Placer and OrderResult Tracker of the scheduled work.

2480

LAB-5, LAB-1 and LAB-3 interactions: After technical validation by a laboratory
technician (Marc Techos), the Automation Manager sends back all the observations to theOrder Filler.
LAB-1 and LAB-3 interactions: After clinical validation, the Order Filler notifies the results
to the Order Result Tracker, and notifies the status change to the Order Placer. The lastinteraction in transaction LAB-3 shows a a negative acknowledgement and a repetition of themessage followed by the final positive acknowledgement.
9.4.2 Interaction diagram
Order Placer

Order Filler

Automation
Manager

Order Result
Tracker

Order enteredspecimensent tolaboratory

OML^O21 (NW)
9.4.3.1

Specimens checked.
Order started
OML^O21 (NW)
9.4.3.2

OML^O21 (SC)9.4.3.3

OUL^R24 (NW)
9.4.3.4

OUL^R24 (SC)9.4.3.5

technical
validation

Clinical validation
OML^O21 (SC)9.4.3.6

OUL^R24 (SC) 9.4.3.7
ACK^R24 (ERR)
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9.4.3 Messages
9.4.3.1 LAB-1 (OP  OF):Message“New or
der
”wi
t
honespeci
men
2490

2500

A new placer order sent to the Order Filler:
MSH|^~\&|OP|Nephrology|OF|Chemistry|200310060820||OML^O21^OML_O21|001|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
ORC|NW|9876543^Nephro||777^Nephro|||||200310060710|^NURSE^JANET|||||||||||
Nephrology^^^^^^FI^^^NE03
TQ1|1||||||||R
OBR|1|9876543^Nephro||82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN|S|||||^NEPHRO^^^^DR
OBX|1|NM|13362-9^URINE COLLECTION DURATION^LN||24|hr|||||F|||200309060735
OBX|2|NM|19153-6^URINE SPECIMEN VOLUME^LN||2500|ml|||||F|||200309060735
SPM|1|||SER|||||||P||||||200310060735|||||||||1
SPM|2|||UR|||||||P||||||200310060735|||||||||1

Ther
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9.4.3.2 LAB-4 (OF  AM):Message“New order”A new work order is sent to the Automation Manager:
2510

2520

MSH|^~\&|OF|Chemistry|AM|Automation|200310060825||OML^O21^OML_O21|011|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
ORC|NW|||777^Nephro |||||200310060710|^NURSE^JANET|||||||||||
Nephrology^^^^^^FI^^^NE03
TQ1|1||||||||R
OBR|1|654^chemistry||82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN|S|||||^NEPHRO^^^^DR
OBX|1|NM|13362-9^URINE COLLECTION DURATION^LN||24|hr|||||F|||200309060735
OBX|2|NM|19153-6^URINE SPECIMEN VOLUME^LN||2500|ml|||||F|||200309060735
SPM|1|654_1^chemistry||SER|||||||P||||||200310060735|200310060821||||||||1
SPM|2|654_2^chemistry||UR|||||||P||||||200310060735|200310060821||||||||1

Ther
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l
a
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da
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s
s
a
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ts
hown.
9.4.3.3 LAB-1 (OF  OP):Message“Statuschanged”
The placer order has been assigned a filler order number, the specimen is available andidentified by the laboratory:

2530

MSH|^~\&|OF|Chemistry|OP|Nephrology|200310060825||OML^O21^OML_O21|012|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
ORC|SC|9876543^Nephro||777^Nephro|IP||||200310060710|^NURSE^JANET|||||||||||
Nephrology^^^^^^FI^^^NE03
TQ1|1||||||||R
OBR|1|9876543^Nephro|654^chemistry|82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN|P|||||^NEPHRO^^^^DR|||||||||I
SPM|1|654_1^chemistry||SER|||||||P||||||200310060735|200310060821||Y||||||1
SPM|2|654_2^chemistry||UR|||||||P||||||200310060735|200310060821||Y||||||1

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l
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2540

9.4.3.4 LAB-3 (OF->ORT):Message“New Or
der”
The Order Result Tracker is notified with the creation of the filler order:

2550

MSH|^~\&|OF|Chemistry|ORT||200310060825||OUL^R24^OUL_R24|013|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
OBR|1|9876543^Nephro|654^chemistry|82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN|P|||||^NEPHRO^^^^DR|||||||||I
ORC|SC|9876543^Nephro||777^Nephro|IP||||200310060710|^NURSE^JANET|||||||||||
Nephrology^^^^^^FI^^^NE03
TQ1|1||||||||R
OBX|1|NM|13362-9^URINE COLLECTION DURATION^LN||24|hr|||||F|||200309060735
OBX|2|NM|19153-6^URINE SPECIMEN VOLUME^LN||2500|ml|||||F|||200309060735
SPM|1|654_1^chemistry||SER|||||||P||||||200310060735|200310060821||Y||||||1
SPM|2|654_2^chemistry||UR|||||||P||||||200310060735|200310060821||Y||||||1

Ther
e
l
a
t
e
da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.4.3.5 LAB-5 (AM->OF):Message“New Results”
The Automation Manager sends the final results for the work order:
2560

2570

MSH|^~\&|AM|Automation|OF|Nephrology|200310060900||OUL^R24^OUL_R24|3331|T|2.5|||||
USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
OBR|1|654^chemistry||82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN|
P|||||^NEPHRO^^^^DR|||||||200310060832|||F|||||||&TECHOS&MARC^200310060833
ORC|SC||||CM||||200310060710|^NURSE^JANET|||||||||||Nephrology^^^^^^FI^^^NE03
SPM|1|654_1^chemistry||SER|||||||P||||||200310060735|200310060821||Y||||||1
OBX|1|NM|15045-8^SERUM CREATININE^LN||93|umol/l|50-100|N|||F|||200310060830
SPM|2|654_2^chemistry||UR|||||||P||||||200310060735|200310060821||Y||||||1
OBX|1|NM|14684-5^24H URINE CREATININE ^LN||7.06|mmol|8-16 (/24hr)|L|||F|||
200310060830
OBX|2|NM|2164-2^CREATININE CLEARANCE^LN||52.7|ml/min|88-174|L||S|F|||200310060830

The relateda
c
knowl
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dg
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s
s
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9.4.3.6 LAB-1 (OF->OP):Message“StatusChanged”
The clinical expert has performed the clinical validation at 09h29. The order iscompleted:
2580

2590

MSH|^~\&|OF|Nephrology|OP|Nephrology|200310060930||OML^O21^OML_O21|014|T|2.5|||||
USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
ORC|SC|9876543^Nephro||777^Nephro|CM||||200310060710|^NURSE^JANET|||||||||||
Nephrology^^^^^^FI^^^NE03
TQ1|1||||||||R
OBR|1|9876543^Nephro|654^chemistry|82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN|P|||||^NEPHRO^^^^DR|||||||||F|||||||&CYTO&JANE^200310060929
SPM|1|654_1^chemistry||SER|||||||P||||||200310060735|200310060821||Y||||||1
SPM|2|654_2^chemistry||UR|||||||P||||||200310060735|200310060821||Y||||||1

Ther
e
l
a
t
e
da
c
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e
dg
e
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ntme
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s
a
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9.4.3.7 LAB-3 (OF->ORT):Message“StatusChanged”
The clinical expert has performed the clinical validation at 09h29. The order iscompleted. The results are final:

2600

2610

MSH|^~\&|OF|Chemistry|ORT||200310060931||OUL^R24^OUL_R24|015|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
OBR|1|9876543^Nephro|654^chemistry |82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN |P|||||^NEPHRO^^^^DR|||||||200310060929|||F|||||||&CYTO&JANE^200310060929
ORC|SC|9876543^Nephro||777^Nephro|CM||||200310060710|^NURSE^JANET|||||||||||
Nephrology^^^^^^FI^^^NE03
TQ1|1||||||||R
SPM|1|654_1^chemistry||SER|||||||P||||||200310060735|200310060821||Y||||||1
OBX|1|NM|15045-8^SERUM CREATININE^LN||93|umol/l|50-100|N|||F|||200310060830
SPM|2|654_2^chemistry||UR|||||||P||||||200310060735|200310060821||Y||||||1
OBX|1|NM|13362-9^URINE COLLECTION DURATION^LN||24|hr|||||F|||200309060735
OBX|2|NM|19153-6^URINE SPECIMEN VOLUME^LN||2400|ml|||||F|||200309060735
OBX|3|NM|14684-5^24H URINE CREATININE^LN||7.06|mmol|8-16 (/24hr)|L|||F|||
200310060830
OBX|4|NM|2164-2^CREATININE CLEARANCE^LN||52.7|ml/min|88-174|L||S|F|||200310060830

Negative acknowledgement sent by the Order Results Tracker:
The ERR-4=‘
E’indicates that the message could not be integrated. The ERR-3 HL7 error
code = 206 informs of the cause: a database locked. The MSA-1=‘
AE’a
s
kst
hes
e
nde
rt
o
repeat its message later.

2620

MSH|^~\&|ORT||OF|Cytology|200310060932||ACK^R24|401|T|2.5|||||USA|EN
MSA|AE|015
ERR|||206^Application record locked|E

Repetition of the same result message by the Order Filler, one minute later

2630

2640

MSH|^~\&|OF|Chemistry|ORT||200310060931||OUL^R24^OUL_R24|015|T|2.5|||||USA||EN
PID|1||6543210^^^Abbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
OBR|1|9876543^Nephro|654^chemistry |82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN |P|||||^NEPHRO^^^^DR|||||||200310060929|||F|||||||&CYTO&JANE^200310060929
ORC|SC|9876543^Nephro||777^Nephro|CM||||200310060710|^NURSE^JANET|||||||||||
Nephrology^^^^^^FI^^^NE03
TQ1|1||||||||R
SPM|1|654_1^chemistry||SER|||||||P||||||200310060735|200310060821||Y||||||1
OBX|1|NM|15045-8^SERUM CREATININE^LN||93|umol/l|50-100|N|||F|||200310060830
SPM|2|654_2^chemistry||UR|||||||P||||||200310060735|200310060821||Y||||||1
OBX|1|NM|13362-9^URINE COLLECTION DURATION^LN||24|hr|||||F|||200309060735
OBX|2|NM|19153-6^URINE SPECIMEN VOLUME^LN||2400|ml|||||F|||200309060735
OBX|3|NM|14684-5^24H URINE CREATININE^LN||7.06|mmol|8-16 (/24hr)|L|||F|||
200310060830
OBX|4|NM|2164-2^CREATININE CLEARANCE^LN||52.7|ml/min|88-174|L||S|F|||200310060830

Positive acknowledgement sent by the Order Results Tracker:
MSH|^~\&|ORT||OF|Cytology|200310060935||ACK^R24|401|T|2.5|||||USA|EN
MSA|AA|015

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9.5 Microbiology with two specimens and three germs identified
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9.5.1 Storyboard
This storyboard illustrates the use of transaction LAB-2 to notify generated batteries at theOrder Filler level (i.e. antibiotic susceptibilities, within the same placer group number).
Dr Physician orders Microscopy and Culture for two different specimens collected from thesame patient. The first specimen is Mid Stream Urine and the second one is Pus taken from awound on patient's left toe. Since several batteries could be performed on each specimen (e.g.
Microscopy and Culture, identification of organism, Antibiotic Susceptibility) the Order
Placer transmits an OML^O33 message. Since both specimens are part of the sameprescription, they are grouped via the Placer Group Number '777'.
The patient is an Outpatient in Emergency ward.

2660

We presume that all tests are performed manually and that results are directly entered by thelaboratory technician in the Order Filler system, there is then neither LAB-4, nor LAB-5transaction in this story board. We also presume that results for observations related to theurine specimen are transferred as soon they are available, whilst the Clinical Expert desires toreview results related to other specimen types before they are released.
Human actors and organizations participating to the process:

2670

Assigning authority: Memphis Hosp 1
Placer:Emergency Ward
Filler:Microbiology
Ordering facility:
Emergency Ward
Patient:
Adam Everyman Jr, account number: 12345 (check-digit 5 modulo 10),class = outpatient.
Order placed by:
Dr PHYSICIAN, phone number 821, ID number in the hospital 222222.
Placer order enterer: Nancy NURSE, ID number 222221
Specimen collector: Nancy NURSE, ID number 222221
Technician:Terry BACK, ID number 333231
Clinical expert:
Mike ROSCOP, ID number 444642.
ID numbers used by the workflow:
ID number
Patient ID
Care unit order for Urine Spec.
Care unit order for Pus Spec.
Care unit order group
1st specimen
2nd specimen
Laboratory order for the Urine
Laboratory order for the PUS

Rev. 1.1–Final Text 08/07/2004

102

Value
12345
12345679
12345670
777
123456791
123456701
MSU0309922
PUS0300666

Assigned by
Admission office (ADT)
Emergency Ward (OP)Emergency Ward (OP)Emergency Ward (OP)Emergency Ward (OP)Emergency Ward (OP)
Microbiology laboratory (OF)Microbiology laboratory (OF)Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

2680

Day 1 at 8:10 LAB-1 interaction: The two specimens are collected and transmitted to theMicrobiology laboratory in Routine. The Orde
rPl
a
c
e
rs
e
ndsame
s
s
a
g
e“
ne
wor
de
r
”(
NW)t
o
the order placer.
Day 1 at 8:20 LAB-1 and LAB-3 interactions: The laboratory checks the specimens andschedules the work. The Order Filler notifies both Order Placer and Order Result Tracker ofthe scheduled work.
Day 1 at 14:46 LAB-1 and LAB-3 interactions: After Microscopy for the Urine Specimen
is achieved, the Order Filler notifies these partial results to the Order Result Tracker, andnotifies the status change to the Order Placer, without waiting for the clinical validation.

2690

2700

Day 2 at 09:40 LAB-2 and LAB-3 interactions: The following day, the Urine culture ispositive, the laboratory adds Organism identification and Antibiotic Susceptibility test for thisspecimen. The Order Filler requires a Placer Order Number to the Order Placer for the added
tests (Transaction LAB-2) and notifies this action to the Order Result Tracker via transaction
LAB-3. There is no need for LAB-1 transaction as the Result status for Urine Microscopy
and Culture has not changed.
Day 2 at 09:45 LAB-1, LAB-2 and LAB-3 interactions: The result of Microscopy andCulture is positive for the Pus specimen, the clinical expert has validated these preliminary
results and the laboratory adds Organism identification and Antibiotic Susceptibility test forthis specimen. The Order Filler notifies the new result status to the Order Placer (Transaction
LAB-1), it requires a Placer Order Number to the Order Placer for the added tests(Transaction LAB-2) and it notifies this action to the Order Result Tracker via transaction
LAB-3.
Day 3 at 11:32 LAB-1 and LAB-3 interactions: The next day, organism identification andAntibiotic Susceptibility tests are achieved; final results are transmitted to the Order Result
Tracker after the clinical validation has been performed. The Order Filler notified the statuschange to the Order Placer.

Rev. 1.1–Final Text 08/07/2004

103

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9.5.2 Interaction diagram

2710

Rev. 1.1–Final Text 08/07/2004

104

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

2710

9.5.3 Messages
9.5.3.1 LAB-1 (OP  OF):Message“New or
der
”wi
t
ht
wospecimens
Day 1 at 8:10 A new placer order sent to the Order Filler.

2720

MSH|^~\&|OP|Emergency Ward|OF|Microbiology|200309060810||OML^O33^OML_O33|msgOP123|
T|2.5|123 ||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream Urine^L|||||||P||||||
200309060800|||||||||1
ORC|NW|12345679^Emergency||777^Emergency|||||200309060800|222221^NURSE^NANCY|||||||||||Emergency Ward^^^^^^FI^^^EW00
TQ1|||||||||R
OBR|1|12345679^Emergency||87086^Urine Microscopy and Culture^CPT4|||||||S|||||
222222^PHYSICIAN^^^^DR|
SPM|2|123456701^Emergency||PUS||||TOE|LEFT||P||||||200309060805|||||||||1
ORC|NW|12345670^Emergency||777^Emergency|||||200309060800|222221^NURSE^NANCY|||||||||||Emergency Ward^^^^^^FI^^^EW00
TQ1|||||||||R
OBR|1|12345670^Emergency||87040^Microscopy and Culture^CPT4||||||222221^NURSE^NANCY|S|||||222222^PHYSICIAN^^^^DR|

2730
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ntme
s
s
a
gei
s
n’
ts
hown.
9.5.3.2 LAB-1 (OF  OP):Message“Statuschanged”
Day 1 at 8:20 Specimens have been received by the laboratory. A filler order number
has been assigner to the order.

2740

MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309060820||OML^O33^OML_O33|msgOF11|
T|2.5|123 ||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream
Urine^L|||||||P||||||200309060800|200309060818||Y|…
ORC|SC|12345679^Emergency||777^Emergency|IP||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBR|1|12345679^Emergency|MSU0309922^Micro|87086^Urine Microscopy andCulture^CPT4|||||||S|||||222222^PHYSICIAN^^^^DR|
SPM|2|123456701^Emergency||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
ORC|SC|12345670^Emergency||777^Emergency|IP||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBR|1|12345670^Emergency|PUS0300666^Micro|87040^Microscopy and Culture^CPT4||||||222221^NURSE^NANCY |S|||||222222^PHYSICIAN^^^^DR|

2750
Ther
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a
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da
c
knowl
e
dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.5.3.3 LAB-3 (OF  ORT)
:Message“New order”Day 1 at 8:20 The Order Result Tracker is notified with the creation of the filler order:

2760

MSH|^~\&|OF|Microbiology|ORT||200309060820||OUL^R22^OUL_R22|msgOF12|T|2.5|123||||
USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream
Urine^L|||||||P||||||200309060800|200309060818||Y|…
OBR|1|12345679^Emergency|MSU0309922^Micro|87086^Urine Microscopy andCulture^CPT4||||||| |||||222222^PHYSICIAN^^^^DR|
ORC|SC|12345679^Emergency||777^Emergency|IP||||200309060818||||||||||||

Rev. 1.1–Final Text 08/07/2004

105

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
Emergency Ward^^^^^^FI^^^EW00
SPM|2|123456701^Emergency||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
OBR|1|12345670^Emergency|PUS0300666^Micro|87040^Microscopy andCulture^CPT4||||||222221^NURSE^NANCY ||||||222222^PHYSICIAN^^^^DR|
ORC|NW|12345670^Emergency||777^Emergency|IP||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00

2770

Ther
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e
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ntme
s
s
a
gei
s
n’
ts
hown.
9.5.3.4 LAB-1 (OF  OP):Message“Statuschanged”
Day 1 at 14:46 Urine Microscopy results are available, not clinically validated (i.e. notverified)2780

MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309061446||OML^O33^OML_O33|msgOF13|
T|2.5|123 ||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream Urine^L|||||||P||||||200309060800|
200309060818||Y|…
ORC|SC|12345679^Emergency||777^Emergency|A||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBR|1|12345679^Emergency|MSU0309922^Micro|87086^Urine Microscopy and culture^CPT4|||||||P|||| |222222^PHYSICIAN^^^^DR|

Ther
e
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a
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ntme
s
s
a
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s
n’
ts
hown.
9.5.3.5 LAB-3 (OF  ORT)
:Message“Statuschanged”
2790

2800

2810

Day 1 at 14:46 Urine Microscopy results are sent, not clinically validated (i.e. notverified):
MSH|^~\&|OF|Microbiology|ORT||200309061446||OUL^R22^OUL_R22|msgOF14|T|2.5|123||||US
A||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream
Urine^L|||||||P||||||200309060800|200309060818||Y|…
OBR|1|12345679^Emergency|MSU0309922^Micro|87086^Urine Microscopy andCulture^CPT4||||||| |||||222222^PHYSICIAN^^^^DR||||||||MB|A
ORC|SC|12345679^Emergency||777^Emergency|A||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
TQ1|||||||||R
OBX|1|CE|20453-7^Epithelial Cells^LN||value|||N|||R|||200309061445||333231^BACK^TERRY
OBX|2|NM|20455-2^Leukocytes^LN||value|/ml||N|||R|||200309061445| |333231^BACK^TERRY
OBX|3|NM|32776-7^Erythrocytes^LN||value|/ml||N|||R|||200309061445||333231^BACK^TERRY
OBX|4|CE|24124-0^Casts^LN||value|||N|||R|||200309061445||333231^BACK^TERRY
OBX|5|NM|699-9^Organism Count^LN||value|/ml||N|||R|||200309061445||333231^BACK^TERRY
OBX|6||20430-5^Culture^LN|||||N|||I|||200309070935||333231^BACK^TERRY

Ther
e
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a
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ntme
s
s
a
gei
s
n’
ts
hown.
9.5.3.6 LAB-2(OF  OP):Message“SendOr
derNumber”
Day 2 at 9:40 Urine Culture is positive, Organism Identification and Antibiotic
Susceptibility tests are added:

Rev. 1.1–Final Text 08/07/2004

106

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2820

2830

MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309070940||OML^O33^OML_O33|msgOF15|
T|2.5|123 ||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream
Urine^L|||||||P||||||200309060800|200309060818||Y|…
ORC|SN|||777^Emergency|||||200309070938|333231^BACK^TERRY|||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBR|1||MSU0309922^Micro|87088^Organism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
ORC|SN|||777^Emergency|||||200309070938|333231^BACK^TERRY|||||||||||Emergency
Ward^^^^^^FI^^^EW00
OBR|2||MSU0309922^Micro|87186^Antibiotic Susceptibility^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB

Acknowledgement sent by the Order Placer:

2840

2850

MSH|^~\&|OP|Emergency
Ward|OF|Microbiology|200309070940||ORL^O34^ORL_O34|msgOP123|T|2.5|123 ||||USA||EN
MSA|AA| msgOF15
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
SPM|1|123456791^Emergency||MSU^Mid Stream
Urine^L|||||||P||||||200309060800|200309060818||Y|…
ORC|NA|12345681^Emergency||777^Emergency|||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|1|12345681^Emergency|MSU0309922^Micro|87088^Organism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
ORC|NA|12345682^Emergency||777^Emergency|||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|2|12345682^Emergency|MSU0309922^Micro|87186^Antibiotic
Susceptibility^CPT4||||||| G|||||222222^PHYSICIAN^^^^DR||||||||MB

9.5.3.7 LAB-3 (OF  ORT)
:Message“StatusChanged”
Day 2 at 09:42 Result for Urine Microscopy and Culture are available. Organism
Identification and Antibiotic Susceptibility tests have been added
Note: The Order Placer has acknowledged transaction LAB-2 and an Order Placer
Number has been added to each test added by the laboratory

2860

2870

2880

MSH|^~\&|OF|Microbiology|ORT||200309070942||OUL^R22^OUL_R22|msgOF16|T|2.5|123||||US
A||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream Urine^L|||||||P||||||200309060800|
200309060818||Y|…
OBR|1|12345679^Emergency|MSU0309922^Micro|87086^Urine Microscopy andCulture^CPT4||||||| |||||222222^PHYSICIAN^^^^DR||||||||MB|R
ORC|SC|12345679^Emergency||777^Emergency|A||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
TQ1|||||||||R
OBX|1|CE|20453-7^Epithelial Cells^LN||value|||N|||R|||200309061445||333231^BACK^TERRY
OBX|2|NM|20455-2^Leukocytes^LN||value|/ml||N|||R|||200309061445| |333231^BACK^TERRY
OBX|3|NM|32776-7^Erythrocytes^LN||value|/ml||N|||R|||200309061445||333231^BACK^TERRY
OBX|4|CE|24124-0^Casts^LN||value|||N|||R|||200309061445||333231^BACK^TERRY
OBX|5|NM|699-9^Organism Count^LN||value|/ml||N|||R|||200309061445||333231^BACK^TERRY
OBX|6|CE|20430-5^Culture^LN||2ORG^Two Organisms^L|||N|||R|||200309070935||333231^BACK^TERRY
OBR|2|12345681^Emergency|MSU0309922^Micro|87088^Organism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB|S

Rev. 1.1–Final Text 08/07/2004

107

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions
ORC|SC|12345681^Emergency||777^Emergency|IP||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|3|12345682^Emergency|MSU0309922^Micro|87186^Antibiotic
Susceptibility^CPT4||||||| G|||||222222^PHYSICIAN^^^^DR||||||||MB|S
ORC|SC|12345682^Emergency||777^Emergency|IP||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00

The related acknowledgement message i
s
n’
ts
hown.
2890

2900

9.5.3.8 LAB-1 (OF  OP):Message“Statuschanged”
Day 2 at 09:45 Microscopy and Culture results are available for the Pus specimen,
MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309070940||OML^O33^OML_O33|msgOF17|
T|2.5| 123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456701^Emergency||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
ORC|SC|12345670^Emergency||777^Emergency|A||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBR|1|12345670^Emergency|PUS0300666^Micro|87040^Microscopy and Culture^CPT4||||||||||||222222^PHYSICIAN^^^^DR|

Ther
e
l
a
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e
da
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dg
e
me
ntme
s
s
a
gei
s
n’
ts
hown.
9.5.3.9 LAB-2(OF  OP):Message“SendOr
derNumber”
Day 2 at 9:45 Culture for Pus specimen is positive, Organism Identification andAntibiotic Susceptibility tests are added:
2910

2920

MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309070945||OML^O33|msgOF18|T|2.5|123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456701^Emergency||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
ORC|SN|||777^Emergency|||||200309070941|333231^BACK^TERRY|||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBR|1||PUS0300666^Micro|87088^Organism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
ORC|SN|||777^Emergency|||||200309070941|333231^BACK^TERRY|||||||||||
Emergency Ward^^^^^^FI^^^EW00 OBR|2||PUS0300666^Micro|87186^Antibiotic
Susceptibility^CPT4||||||| G|||||222222^PHYSICIAN^^^^DR||||||||MB

Acknowledgement sent by the Order Placer:

2930

MSH|^~\&|OP|Emergency
Ward|OF|Microbiology|200309070945||ORL^O34^ORL_O34|msgOP124|T|2.5| 123||||USA||EN
MSA|AA|msgOF18
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
SPM|1|123456701^Emergency||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
ORC|NA|12345685^Emergency||777^Emergency|||||200309070941|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|1|12345685^Emergency|PUS0300666^Micro|87088^Organism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
ORC|NA|12345686^Emergency||777^Emergency|||||200309070941|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|2|12345686^Emergency|PUS0300666^Micro|87186^Antibiotic
Susceptibility^CPT4|||||||G|||||222222^PHYSICIAN^^^^DR||||||||MB

Rev. 1.1–Final Text 08/07/2004

108

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9.5.3.10 LAB-3 (OF  ORT)
:Message“StatusChanged”
2940

Day 2 at 09:45 The Clinical Expert has validated the preliminary results of Microscopy
and culture for the Pus Specimen.
Note: Although the Culture is positive, the result status is not "Final" other
Organisms may grow during the next 24 hours. Results of culture will be considered
as final on Day 3 after 48 hours of incubation.

2950

2960

MSH|^~\&|OF|Microbiology|ORT||200309070945||OUL^R22^OUL_R22|msgOF19|T|2.5|123||||
USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456701^Emergency ||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
OBR|1|12345670^Emergency|PUS0300666^Micro|87040^Microscopy andCulture^CPT4||||||222221^NURSE^NANCY||||||222222^PHYSICIAN^^^^DR||||||||MB|P|||||||444642&ROSCOP&Mike^200309070944
ORC|SC|1234567O^Emergency||777^Emergency|A||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBX|1|NM|32761-9^Leukocytes^LN||value|||N|||F|||200309061125||333231^BACK^TERRY
OBX|2|NM|32762-7^Epithelial Cells^LN||value|||N|||F|||200309061125||333231^BACK^TERRY
OBX|3|CE|20430-5^Culture^LN||POS^Positive^L|||N|||P|||200309070935||333231^BACK^TERRY
OBR|2|12345685^Emergency|PUS0300666^Micro|87088^Organism Identification^CPT4|||||||
G||||| ||||||||MB|S
ORC|SC|12345685^Emergency||777^Emergency|IP||||200309070941|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|3|12345686^Emergency|PUS0300666^Micro|87186^Antibiotic
Susceptibility^CPT4||||||| G||||| ||||||||MB|S
ORC|SC|12345686^Emergency||777^Emergency|IP||||200309070941|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00

2970
Ther
e
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ntme
s
s
a
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s
n’
ts
hown.
9.5.3.11 LAB-1 (OF  OP):Message“Statuschanged”
Day 3 at 11:32 Mike ROSCOP has performed the clinical validation at 11h30. The
order is completed.

2980

2990

MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309081132||OML^O33^OML_O33|msgOF20|
T|2.5|123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream
Urine^L|||||||P||||||200309060800|200309060818||Y|…
ORC|SC|12345679^Emergency||777^Emergency|CM||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBR|1|12345679|MSU0309922^Micro|87086^Urine Microscopy and Culture^CPT4||||||||||||
222222^PHYSICIAN^^^^DR|
ORC|SC|12345681^Emergency||777^Emergency|CM||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|2|12345679|MSU0309922^Micro|87088^Organism Identification^CPT4||||||||||||
222222^PHYSICIAN^^^^DR|
ORC|SC|12345682^Emergency||777^Emergency|CM||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|3|12345679|MSU0309922^Micro|87186^Antibiotic Susceptibility^CPT4||||||||||||
222222^PHYSICIAN^^^^DR
SPM|2|123456701^Emergency||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
ORC|SC|12345670||777^Emergency|CM||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^^EW00
OBR|1|12345670^Emergency|PUS0300666^Micro|87040^Microscopy andCulture^CPT4|||||||||||| 222222^PHYSICIAN^^^^DR|

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3000

ORC|SC|12345685^Emergency||777^Emergency|CM||||200309070941|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|2|12345670|PUS0300666^Micro|87072^Organism Identification^CPT4||||||||||||ORC|SC|12345686^Emergency||777^Emergency|CM||||200309070941|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBR|3|12345670|PUS0300666^Micro|87186^Antibiotic Susceptibility^CPT4||||||||||||

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9.5.3.12 LAB-3 (OF  ORT)
:Message“Statuschanged”
3010

Day 3 at 11:32 Mike ROSCOP has performed the clinical validation at 11h30. Final
results are transmitted.
Note: In this message, the OBX-4 (Observation Sub-ID) is used to associate theresults of each Antibiotic in the Susceptibility test to the appropriate organism.
For the URINE specimen, the value 1 in the SUB ID field is used for the firstorganism (E.Coli) whilst the value 2 is used for the second organism (Strepto D).
Although in the following example antibiotic susceptibility results for the twoorganisms are grouped under a single OBR segment, it could have been possible touse one OBR segment for the susceptibility test of each organism.

3020

3030

3040

3050

3060

MSH|^~\&|OF|Microbiology|ORT||200309081132||OUL^R22^OUL_R22|msgOF21|T|2.5|
123||||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMAN^ADAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791^Emergency||MSU^Mid Stream
Urine^L|||||||P||||||200309060800|200309060818||Y|…
OBR|1|12345679^Emergency|MSU0309922^Micro|87086^Urine Microscopy andCulture^CPT4||||||||||||222222^PHYSICIAN^^^^DR||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
ORC|SC|12345679^Emergency||777^Emergency|CM||||200309060818||||||||||||Emergency
Ward^^^^^^FI^^^EW00
TQ1|||||||||R
OBX|1|CE|20453-7^Epithelial Cells^LN||value|||N|||F|||200309061445||333231^BACK^TERRY
OBX|2|NM|20455-2^Leukocytes^LN||value|/ml||N|||F|||200309061445|…
OBX|3|NM|32776-7^Erythrocytes^LN||value|/ml||N|||F|||200309061445|…
OBX|4|CE|24124-0^Casts^LN||value|||N|||F|||200309061445||333231^BACK^TERRY
OBX|5|NM|699-9^Organism Count^LN||value|/ml||N|||F|||200309061445|…
OBX|6|CE|20430-5^Culture^LN||2ORG^Two Organisms^L|||N|||F|||200309070935|…
OBR|2|12345679^Emergency|MSU0309922^Micro|87088^Organism Identification^CPT4|||||||||||| ||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
ORC|SC|12345681^Emergency||777^Emergency|CM||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBX|1|NM|11475-1^Micro organism identified^LN|1|E. Coli|||N|||F|||…
OBX|2|NM|11475-1^Micro organism identified^LN|2|Strepto D|||N|||F|||…
OBR|3|12345679^Emergency|MSU0309922^Micro|87186^Antibiotic Susceptibility^CPT4||||||||||||||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
ORC|SC|12345681^Emergency||777^Emergency|CM||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBX|1|SN|18861-5^Amoxicillin^LN|1|>=0.512|µg/ml||R|||F|||200309081107|…
OBX|2|SN|18864-9^Ampicillin^LN|1|<0.128|µg/ml||I|||F|||200309081107|…
OBX|3|SN|18952-2^Nalidixate^LN|1|>=2.0|µg/ml||R|||F|||200309081107|…
OBX|4|SN|18956-3^Norfloxacin^LN|1|value|µg/ml||I|||F|||200309081107|…
OBX|5|SN|18928-2^Gentamicin^LN|1|<0.032|µg/ml||S|||F|||200309081107|…
OBX|6|SN|25596-8^Fosfomycine^LN|1|<0.1|µg/ml||S|||F|||200309081107|…
OBX|7|SN|18955-5^Nitrofuranton^LN|1|<0.25|µg/ml||S|||F|||200309081107|…
OBX|8|SN|18965-4^Penicillin G^LN|2|<0.5|µg/ml||S|||F|||200309081107|…
OBX|9|SN|18861-5^Amoxicillin^LN|2|value|µg/ml||S|||F|||200309081107|…
OBX|10|SN|18864-9^Ampicillin^LN|2|value|µg/ml||S|||F|||200309081107|…
OBX|11|SN|18928-2^Gentamicin^LN|2|value|µg/ml||R|||F|||200309081107|…
OBX|12|SN|18917-5^Doxycycline^LN|2|value|µg/ml||R|||F|||200309081107|…
OBX|13|SN|18919-1^Erythromycin^LN|2|value|µg/ml||R|||F|||200309081107|…
OBX|14|SN|18974-6^Rifampicin^LN|2|value|µg/ml||S|||F|||200309081107|…

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3070

3080

3090

OBX|15|SN|18938-1^Lincomycin^LN|2|value|µg/ml||R|||F|||200309081107|…
SPM|2|123456701^Emergency||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
OBR|1|12345670^Emergency|PUS0300666^Micro|87040^Microscopy andCulture^CPT4||||||222221^NURSE^NANCY||||||222222^PHYSICIAN^^^^DR||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
ORC|SC|12345670^Emergency||777^Emergency|CM||||200309060818||||||||||||Emergency
Ward^^^^^^FI^^^EW00
OBX|1|CE|32761-9^Leukocytes^LN||value|||N|||F|||200309060830
OBX|2|CE|32762-7^Epithelial Cells^LN||value|||N|||F|||200309060830||333231^BACK^TERRY
OBX|3|CE|20430-5^Culture^LN||POS^Positive^L|||N|||F|||200309070935|…
|333231^BACK^TERRY
OBR|2|12345670^Emergency|PUS0300666^Micro|87072^Organism
Identification^CPT4|||||||||||| ||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
ORC|SC|12345685^Emergency||777^Emergency|CM||||200309070941|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBX|1|NM|21020-3^Micro organism identified^LN|1|Staph Aureus|||N|||F|||200309080830|…
OBR|3|12345670^Emergency|PUS0300666^Micro|87186^Antibiotic
Susceptibility^CPT4|||||||||||| ||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
ORC|SC|12345686^Emergency||777^Emergency|CM||||200309070938|333231^BACK^TERRY|||||||||||Emergency Ward^^^^^^FI^^^EW00
OBX|1|SN|18928-2^Gentamicin^LN|1|value|µg/ml||S|||F|||200309080830|…
OBX|2|SN|18996-9^Tobramycin^LN|1|value|µg/ml||R|||F|||200309080830|…
OBX|3|SN|18954-8^Netilmicin^LN|1|value|µg/ml||S|||F|||200309080830|…
OBX|4|SN|18959-7^Ofloxacin^LN|1|value|µg/ml||S|||F|||200309080830|…
OBX|5|SN|18917-5^Doxycycline^LN|1|value|µg/ml||S|||F|||200309080830|…
OBX|6|SN|19000-9^Vancomycin^LN|1|value|µg/ml||S|||F|||200309080830|…
OBX|7|SN|18974-6^Rifampicin^LN|1|value|µg/ml||S|||F|||200309080830|…
OBX|8|SN|25596-8^Fosfomycine^LN|1|value|µg/ml||S|||F|||200309080830|…

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10 Relationship between Transactions and messages/trigger
events
3100

The following tables list all the combinations of message types and trigger events that can be used byeach Transaction on IHE Laboratory Framework.
OML, ORL and OUL message types use a primary trigger event stored in second component of MSH9, which describes the message structure (O21, O22, O33, O34, O35, O36), and a secondary trigger
event stored in ORC-1(
Or
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umni
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formatted: primary event/secondary event.
For OUL message types the content of the field OBR-25 (Results Status) gives a precision on the
global status of the results of the order. The values of this field are shown in an additional column inthe tables for transaction LAB-3 and LAB-5.

3110

ADT message types use only the classical trigger event stored in second component of MSH-9.

Transaction RAD-1: Patient Registration
Transaction
Message Trigger event
definition
type
Patient Registration ADTInpatient/outpatient notice
Registration of an outpatient patient
Preadmission of an inpatient
Cancel Admit Register Patient
Cancel Preadmission of an inpatient

Event
type
A01
A04
A05
A11
A38

HL-7
Ver2.5Chapter 3

Transaction RAD-12: Patient Information Update
Transaction
Message Trigger event
definition
type
Patient Information ADT
Patient Transfer
UpdatePatient Discharge
Change an Outpatient to Inpatient
Change an Inpatient to Outpatient
Update Patient Information
Canceling Patient Transfert
Merge Patient

Event
type
A02
A03
A06
A07
A08
A12
A40

HL-7
Ver2.5Chapter 3

3120

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Transaction LAB-1: Placer Order Management
Transaction
Message Trigger event
Event typeHL-7
definition
type
Ver2.5
Placing a new order OML
Laboratory Order Message (Battery Centric)
O21/NW Chapter 4(OP -> OF)
Laboratory Order for multiple orders related to a
O33/NW
single specimen
Laboratory Order for multiple orders related to a
O35/NW
single container of a specimen
Application
ORL
General laboratory order response message to any O22/OK
response to a new
OML
O22/UAorder message
Laboratory order response message to a multiple
O34/OK(OF -> OP)order related to a single specimen OML
O34/UA
Laboratory order response message to a single
O36/OK
container of a specimen OML
O36/UA
Order or battery
OML
Laboratory Order Message
O21/OC
canceled by Order(Battery Centric)
FillerLaboratory Order for multiple orders related to a
O33/OC(OF -> OP)single specimen
Laboratory Order for multiple orders related to a
O35/OC
single container of a specimen
Order Placer
ORL
General laboratory order response message to any O22/OK
application
OML
O22/UA
response to order orLaboratory order response message to a multiple
O34/OK
battery canceled byorder related to a single specimen OML
O34/UA
Order Filler
Laboratory order response message to a single
O36/OK(OP -> OF)
container of a specimen OML
O36/UA
Status Changed
OML
Laboratory Order Message
O21/SC(OF -> OP)(Battery Centric)
Laboratory Order for multiple orders related to a
O33/SC
single specimen
Laboratory Order for multiple orders related to a
O35/SC
single container of a specimen
Application
ORL
General laboratory order response message to any O22/OK
response to a status
OML
O22/UAchangesLaboratory order response message to a multiple
O34/OK(OP -> OF)order related to a single specimen OML
O34/UA
Laboratory order response message to a single
O36/OK
container of a specimen OML
O36/UA
Order service
OML
Laboratory Order Message
O21/RP
replace request by(Battery Centric)
Order Placer
Laboratory Order for multiple orders related to a
O33/RP(OP -> OF)
single specimen
Laboratory Order for multiple orders related to a
O35/RP
single container of a specimen
Order Filler
ORL
General laboratory order response message to any O22/RQ
application
OML
O22/UM

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Transaction
Message Trigger event
Event typedefinition
type
response to order
Laboratory order response message to a multiple
O34/RQ
service replaceorder related to a single specimen OML
O34/UM
request by Order
Laboratory order response message to a single
O36/RQ
Placer (OF -> OP)
container of a specimen OML
O36/UM
Order replaced by OML
Laboratory Order Message
O21/RU
Order Filler(Battery Centric)(OF -> OP)
Laboratory Order for multiple orders related to a
O33/RUsingle specimen
Laboratory Order for multiple orders related to a
O35/RUsingle container of a specimen
Order placer
ORL
General laboratory order response message to any O22/RQ
application
OML
O22/UM
response to order
Laboratory order response message to a multiple
O34/RQ
replaced by Order
order related to a single specimen OML
O34/UM
Filler (OP -> OF)
Laboratory order response message to a single
O36/RQ
container of a specimen OML
O36/UM
Cancel order
OML
Laboratory Order Message
O21/CArequest by Order(Battery Centric)
Placer (OP -> OF)
Laboratory Order for multiple orders related to a
O33/CA
single specimen
Laboratory Order for multiple orders related to a
O35/CA
single container of a specimen
Order Filler
ORL
General laboratory order response message to any O22/CR
application
OML
O22/UC
response to cancel
Laboratory order response message to a multiple
O34/CR
request by Order
order related to a single specimen OML
O34/UC
Placer (OF -> OP)
Laboratory order response message to a single
O36/CR
container of a specimen OML
O36/UC

Transaction LAB-2: Filler Order Management
Transaction
Message Trigger event
definition
type
Send order / service OML
Laboratory Order Message
number request(Battery Centric)(OF -> OP)
Laboratory Order for multiple orders related to asingle specimen
Laboratory Order for multiple orders related to asingle container of a specimen
Acknowledgement ORL
General laboratory order response message to any
to order / service
OML
number request
Laboratory order response message to a multiple(OP -> OF)order related to a single specimen OML
Laboratory order response message to a single
container of a specimen OML

Rev. 1.1–Final Text 08/07/2004

114

Event type
O21/SN
O33/SN
O35/SN
O22/NA or
O22/UA
O34/NA or
O34/UA
O36/NA or
O36/UA

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHIS

HL-7
Ver2.5

HL-7
Ver2.5Chapter 4

IHE Laboratory Technical Framework, vol. 2: Transactions
Transaction LAB-3: Order Results Management
Transaction
Message Trigger event
Event OBR-25 HL-7
definition
type
type
status Ver2.5
Reception of
OUL
Unsolicited specimen oriented observation R22/SC
I
Chapter
specimen(s)message7(no results available,
Unsolicited order oriented observation
R24/SC
I
procedure
messageincomplete)
Some or all of the
OUL
Unsolicited specimen oriented observation R22/SC
R
results available
message
Not validated yet.
Unsolicited order oriented observation
R24/SC
R
message
Preliminary: Some of OUL
Unsolicited specimen oriented observation R22/SC
P
results available,
messagevalidated.
Unsolicited order oriented observation
R24/SCP
message
Final: All results
OUL
Unsolicited specimen oriented observation R22/SC
F
available, validated
message
Unsolicited order oriented observation
R24/SCF
message
Correction of final
OUL
Unsolicited specimen oriented observation R22/SC
C
results results
message
Unsolicited order oriented observation
R24/SCC
message
Deletion of
OUL
Unsolicited specimen oriented observation R22/SC
X
battery/test in a filler
messageorder
Unsolicited order oriented observation
R24/SCX(no results available)
message
Addition of a
OUL
Unsolicited specimen oriented observation R22/SC
S
battery/test in an
messageorder
Unsolicited order oriented observation
R24/SCS(but not done)
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Transaction LAB-4: Work Order Management
Transaction
Message Trigger event
Event type HL-7
definition
type
Ver2.5
Order Filler issues OML
Laboratory order message
O21/NW Chapter
the new order (test4
Laboratory order for multiple orders related to a
O33/NW
request)single specimen(OF -> AM)
Laboratory order for multiple orders related to a
O35/NW
single container of a specimen
Automation
ORL
General laboratory order response message to any O22/OK
Manager responds
OML
O22/UAto new order
Laboratory order response message to a multiple
O34/OK(AM -> OF)order related to single specimen OML
O34/UA
Laboratory order response message to a single
O36/OK
container of a specimen OML
O36/UA
Order Filler
OML
Laboratory order message
O21/RP
replaces the order
Laboratory order for multiple orders related to a
O33/RP(test request)
single specimen(OF -> AM)
Laboratory order for multiple orders related to a
O35/RP
single container of a specimen
Automation
ORL
General laboratory order response message to any O22/RQ
Manager responds
OML
O22/UM
to replace order
Laboratory order response message to a multiple
O34/RQ(AM -> OF)order related to single specimen OML
O34/UM

Order Filler cancels OML
the order (testrequest)(OF -> AM)
Automation
ORL
Manager responds
to cancel order(AM -> OF)

Rev. 1.1–Final Text 08/07/2004

Laboratory order response message to a single
container of a specimen OML

O36RQ
O36UM

Laboratory order message
Laboratory order for multiple orders related to asingle specimen
Laboratory order for multiple orders related to asingle container of a specimen
General laboratory order response message to any
OMLLaboratory order response message to a multipleorder related to single specimen OML
Laboratory order response message to a single
container of a specimen OML

O21/CA
O33/CA

116

O35/CA
O22/CR
O22/UC
O34/CR
O34/UC
O36/CR
O36/UC

Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHISIHE Laboratory Technical Framework, vol. 2: Transactions

Transaction LAB-5: Test Results Management
Transaction definition Message Trigger event
type
Automation Manager
OULtransmits the reception
Unsolicited Specimen Orientedof specimen(s) /Observation Message
container(s)(no results available,
Unsolicited Specimen Container
procedure incomplete)
Oriented Observation Message
Unsolicited Order Oriented
Observation Message
Automation Manager
OULtransmits some (or all)Unsolicited Specimen Orientedof the results
Observation Message
not yet validated
Unsolicited Specimen Container
Oriented Observation Message
Unsolicited Order Oriented
Observation Message
Automation Manager
OULtransmits the
Unsolicited Specimen Oriented
preliminary results
Observation Message(some of results
available, validated)
Unsolicited Specimen Container(AM -> OF)
Oriented Observation Message
Unsolicited Order Oriented
Observation Message
Automation Manager
transmits the final
results(all results available,
validated)

Event
type

OBR-25 HL-7
status Ver2.5
I
Chapter
R22/SC
7

R23/SCI

R24/SCI

R22/SCR

R23/SCR

R24/SCR

R22/SCP

R23/SCP

R24/SCP

Unsolicited Specimen Oriented
Observation Message

R22/SCF

Unsolicited Specimen Container
Oriented Observation Message
Unsolicited Order Oriented
Observation Message

R23/SCF

R24/SCF

Unsolicited Specimen Oriented
Observation Message

R22/SCC

Unsolicited Specimen Container
Oriented Observation Message
Unsolicited Order Oriented
Observation Message

R23/SCC

R24/SCCOULAutomation Manager
OULtransmits the correctionof final results

3130

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11 Outstanding issues
Value of ORC-1 Order Control in the OML message sent by the Order Filler to the Order
Placer to accept an order in transaction LAB-1:Ac
c
or
di
ngt
oHL7v2.
5t
a
bl
e0119
,“
OK”
doe
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obeava
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uef
ora
nOMLme
s
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nd“
RR”i
sonl
yl
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tf
orba
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.The
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f
or
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ue“
SC”(
s
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usc
ha
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d)ha
sbe
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hos
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sha
st
obe
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onf
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,“
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una
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)doe
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l
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ora
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message.
How to represent in HL7 v2.5, the three responsibilities defined in the data model, in astandard way, common to all countries?
3140

The ADT transactions are already defined in Radiology Technical Framework using HL7
version 2.3.1, and are adopted without change by Laboratory Technical Framework. This
framework adopts HL7 version 2.5, which may raise some incompatibility issues.
The results enquiry notification from the Order Result Tracker to the Order Filler ispostponed to a later version of this Technical Framework for the following reasons: This
event is supposed to be audited in the Order Result Tracker. There is no existing trigger event
in HL7 v2.5 that meets this requirement.
For next cycle, two fields should be added: Equipment Instance Identifier (OBX-18) andReagent Lot Number.

3150

This cycle does not address the transmission of Laboratory global reports in specific format(pdf, rtf, txt). The intention is to enable products that will implement the Order Filler to also
support an Information Source actor for the Retrieve Information For Display profile. Several
s
ol
ut
i
ons(
s
pe
c
i
f
i
cORC/
OBR,MDM me
s
s
a
g
e
sofHL72.
5chapter9,…)a
r
ea
va
i
l
a
bl
et
o
convey the RID reference but are to be studied.

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