HL7 LabTFVol2 - v1 - 2 - 1 - Mar16 - FT

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 RATIONALE FOR THE CHOICE OF THE STANDARD TO BE USED ............................................................... 4
2 CONVENTIONS ......................................................................................................................................... 5
2.1 THE GENERIC IHE TRANSACTION MODEL............................................................................................ 5
2.2 HL7 PROFILING CONVENTIONS ............................................................................................................ 5
30 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 .................................................................................................................... 10
2.3.6.1 EI Data Type ....................................................................................................................................... 10
40 2.3.6.2 CX Data Type ..................................................................................................................................... 11
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
50 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
3.12.2.1 ORC-5: Order status ........................................................................................................................... 35
3.12.2.2 OBR-25: Order Result status .............................................................................................................. 35
3.12.2.3 OBX-11: Obsevation Result Status..................................................................................................... 36
3.12.3 Relationship between the 3 status fields................................................................................... 36
60 4 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
70 4.5.2 Restrictions on OML message for transaction LAB-1 .................................................................. 41
4.5.3 OMLÔ21 static definition............................................................................................................ 42
4.5.4 ORLÔ22 static definition ............................................................................................................ 43
4.5.9 Specific segments description for transaction LAB-1 ................................................................... 48
4.5.9.1 OBR - Observation Request Segment ................................................................................................. 48
5 TRANSACTION LAB-2: FILLER ORDER MANAGEMENT ........................................................... 52
Rev. 1.1–Final Text 08/07/2004 1 Copyright © 2003: GMSIH, HPRIM, IHE-J, JAHIS
80 5.1 SCOPE................................................................................................................................................. 52
5.2 USE CASE ROLES................................................................................................................................ 52
5.4.1 Process of a filler order ................................................................................................................ 53
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 OBR - Observation Request Segment ................................................................................................. 54
6 TRANSACTION LAB-3: ORDER RESULTS MANAGEMENT ........................................................ 57
6.1 SCOPE................................................................................................................................................. 57
6.2 USE CASE ROLES................................................................................................................................ 57
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
100 6.5.1 OUL : Unsolicited Laboratory Observation message................................................................... 59
6.5.1.1 OUL^R22 static definition .................................................................................................................. 60
6.5.1.2 OUL^R24 static definition .................................................................................................................. 61
6.6 ACKNOWLEDGEMENT OF OUL MESSAGES ......................................................................................... 66
7 TRANSACTION LAB-4: WORK ORDER MANAGEMENT ............................................................. 67
7.1 SCOPE................................................................................................................................................. 67
7.2 USE CASE ROLES ................................................................................................................................. 67
110 7.5.1 Laboratory Order Message (OMLÔ21, ORLÔ22) .................................................................... 68
7.5.1.1 Trigger events ..................................................................................................................................... 68
7.5.1.2 Message semantics.............................................................................................................................. 68
7.5.2 Laboratory Order for Multiple Orders Related to a Single Specimen (OMLÔ33, ORLÔ34) ... 70
7.5.2.1 Trigger Events..................................................................................................................................... 70
7.5.2.2 Message semantics.............................................................................................................................. 70
7.5.3 Laboratory Order for Multiple Orders related to a Single Container of a Specimen (OMLÔ35,
ORLÔ36) ................................................................................................................................................... 72
7.5.3.1 Trigger Events..................................................................................................................................... 72
7.5.3.2 Message Semantics ............................................................................................................................. 72
120 7.5.3.3 Expected Action.................................................................................................................................. 76
8 TRANSACTION LAB-5: TEST RESULTS MANAGEMENT ............................................................ 77
8.1 SCOPE................................................................................................................................................. 77
8.2 USE CASE ROLES ................................................................................................................................. 77
8.5.1 Trigger Events .............................................................................................................................. 78
8.5.1.1 Message semantics (R22).................................................................................................................... 78
8.5.1.2 Message semantics (R23).................................................................................................................... 79
130 8.5.1.3 Message semantics (R24).................................................................................................................... 80
8.5.1.4 Expected Action.................................................................................................................................. 81
8.5.1.5 OBR segment...................................................................................................................................... 81
8.5.1.6 TCD segment ...................................................................................................................................... 82
9 REAL WORLD USE CASES................................................................................................................... 83
9.1 GUIDELINES........................................................................................................................................ 83
9.2 TWO HEMATOLOGY BATTERIES ON A BLOOD SPECIMEN ..................................................................... 84
9.2.1 Storyboard .................................................................................................................................... 84

9.2.2 Interaction diagram ...................................................................................................................... 85
9.2.3 Messages....................................................................................................................................... 85
140 9.2.3.1 LAB-1 (OP  OF) :Messa
ge“ Newor der”wi thones pe c ime n.......................................................... 85
9.2.3.2 LAB-4 (OF  AM) :Mes
sage“ Newor der
”....................................................................................... 86
9.2.3.3 LAB-1 (OF  OP) :Me s
sage“ St
atuschang e d”................................................................................ 86
9.2.3.4 LAB-3 (OF->ORT) :Message“ NewOr der”....................................................................................... 86
9.2.3.5 LAB-5 (AM->OF) :Me s
sage“ NewRe sult
s”...................................................................................... 87
9.2.3.6 LAB-1 (OF->OP):Me ss
age“ Stat
usCha nged” ................................................................................... 87
9.2.3.7 LAB-3 (OF->ORT) :Message“ St
atusChang e d”................................................................................ 88
9.3 TEST ON A SERIES OF SPECIMENS: GLUCOSE TOLERANCE STUDY....................................................... 89
9.3.1 Storyboard .................................................................................................................................... 89
150 9.3.3 Messages....................................................................................................................................... 91
9.3.3.1 LAB-1 (OP  OF)
:Me s
sage“ Neworder”withthef ir st3s pe ci me ns ............................................... 91
9.3.3.2 LAB-4 (OF  AM):Message“Newor der
”wi tht hef irs t2s pe c ime ns............................................. 92
9.3.3.3 LAB-1 (OF  OP)
:Me ssa
ge“ Sta
tuschanged”wi tht hef ir st3s pe ci me ns ....................................... 92
9.3.3.4 LAB-3 (OF  ORT):Mess
ag e“Newor der
”wi tht hef ir st3s pe cime ns ............................................ 92
9.3.3.5 LAB-5 (AM OF) :Mes
sage“ Newresult
s”forthef ir st2wor kor de r s............................................ 93
9.3.3.6 LAB-1 (OF  OP)
:Me ssa
ge“ Sta
tuschanged”................................................................................ 93
ag e“St
atuschanged”.............................................................................. 93
9.3.3.8 LAB-1(OP  OF):Messa
ge“ Changeorder/
servic er eque s t”............................................................ 94
9.3.3.9 LAB-4 (OF  AM):Message“Newor der
”wi tht hel as t2s pe c ime ns.............................................. 94
160 9.3.3.10 LAB-1 (OF  OP)
:Me ssa
ge“ Sta
tuschanged”wi tha lls pe c ime ns .................................................. 94
ag e“St
atuschanged”.............................................................................. 95
9.3.3.12 LAB-5 (AM OF) :Mes
sage“ Newresult
s”forthel a st2wor kor d er s............................................. 95
9.3.3.13 LAB-1 (OF  OP)
:Me ssa
ge“ Sta
tuschanged”................................................................................ 96
ag e“St
atuschanged”.............................................................................. 96
9.4 BATTERY WITH 2 SPECIMENS: CREATININE CLEARANCE .................................................................... 97
9.4.1 Storyboard .................................................................................................................................... 97
9.4.3 Messages....................................................................................................................................... 99
9.4.3.1 LAB-1 (OP  OF) :Messa
ge“ Newor der”wi thones pe c ime n.......................................................... 99
170 9.4.3.2 LAB-4 (OF  AM) :Mes
sage“ Newor der
”....................................................................................... 99
9.4.3.3 LAB-1 (OF  OP) :Me s
sage“ St
atuschang e d”................................................................................ 99
9.4.3.4 LAB-3 (OF->ORT) :Message“ NewOr der”..................................................................................... 100
9.4.3.5 LAB-5 (AM->OF) :Me s
sage“ NewRe sult
s”.................................................................................... 100
9.4.3.6 LAB-1 (OF->OP):Me ss
age“ Stat
usCha nged” ................................................................................. 100
9.4.3.7 LAB-3 (OF->ORT) :Message“ St
atusChang e d”.............................................................................. 101
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 LAB-1 (OP  OF):Me ssa
ge“ Neworder”wi tht wos pe c ime ns ...................................................... 105
9.5.3.2 LAB-1 (OF  OP):Me ssage“Sta
tuscha nged”.............................................................................. 105
9.5.3.3 LAB-3 (OF  ORT):Me ssage“Newor de r
”................................................................................... 105
tuscha nged”.............................................................................. 106
9.5.3.5 LAB-3 (OF  ORT):Me ssage“St
atuscha nged”............................................................................ 106
9.5.3.6 LAB-2(OF  OP):Me ssage“SendOrde rNumbe r ”........................................................................ 106
atusCha ng ed” ............................................................................ 107
tuscha nged”.............................................................................. 108
9.5.3.9 LAB-2(OF  OP): Message“SendOrde rNumbe r ”........................................................................ 108
atusCha ng ed” ............................................................................ 109
190 9.5.3.11 LAB-1 (OF  OP):Me ssage“Sta
tuscha nged”.............................................................................. 109
atuscha nged”............................................................................ 110
10 RELATIONSHIP BETWEEN TRANSACTIONS AND MESSAGES/TRIGGER EVENTS.......... 112
11 OUTSTANDING ISSUES ...................................................................................................................... 118
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.
This document, Volume 2, provides the detailed description of each new transaction
200 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
At this point in time, HL7 V3 is not ready for implementation in systems, and HL7 V2.5 is
the only available version that supports both specimen and container. Moreover, domain
210 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).
Since we have at least two transactions using the pipe encoding mechanism, this encoding
220 mechanism is required for the messages described in this volume. The XML encoding of
these messages is optional and may be specified in national extensions.
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

The messages used by each transaction are described in this document using static definitions
of "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,
230 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 the
message, 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 the
context of this particular transaction within IHE Laboratory Technical Framework.
The coded values used in this document are:
240 R: Required: A compliant sending application shall populate all "R" elements
with a non-empty value. A compliant receiving application shall process
(save/print/archive/etc.) or ignore the information conveyed by required
elements. A compliant receiving application shall not raise an error due to
the presence of a required element, but may raise an error due to the absence
of 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
250 for the element, then it shall send that element. If the conformant sending
application does not know the required values, then that element may be
omitted.
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").
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 an
error if the condition predicate is false and the element is not present, though
270 it may raise an error if the element IS present.
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 the
context of this particular transaction within IHE Laboratory Technical Framework.

HL7 chapter: Reference of the HL7 v2.5 chapter that describes this segment.
Simplification:
Forabe tterr eadabi
lit
yoft het able ,t
heus
age“
X"i snots hownat the message level: if a
segment 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 Usage Card. HL7 chapter
MSH Message Header R [1..1] 2
[ --- PATIENT begin [1..1]
PID Patient Identification R [1..1] 3
[ --- PATIENT VISIT begin [1..1]
PV1 Patient Visit RE [0..1] 3
2.2.2 Static definition - segment level

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
290  Cardinality: Minimum and maximum number of occurrences for the field in this
particular context of IHE Laboratory Technical Framework. Same meaning as in the
message level.
 TBL#: Table reference (for fields using a set of defined values)
 ITEM#: HL7 unique reference for this field

Element Name: Name of the field.
Simplification :
Forabe tterr eadabil
ityoft het able,theus age“ O"i snots hownat the segment level: All
optional 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. TBL# ITEM# Element name
1 1 ST R [1..1] 00001 Field Separator
2 4 ST R [1..1] 00002 Encoding characters
3 227 HD R [1..1] 0361 00003 Sending Application
…
300
According to HL7 standard, if the value of a field is not present, the receiver shall not
change 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.
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 new
transactions on this network connection.
2.3.2 Message Granularity

A message is generated from one trigger event in the real world. Therefore a message is
related 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.
An OML message shall be acknowledged by one single ORL message. An OUL message
shall be acknowledged by one single ACK message. These acknowledgements are
application-level acknowledgements (i.e. not transport acknowledgements) and must be
330 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 the
message 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
MSA Message Acknowledgement R [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 the
340 value of MSH-9-2-Trigger event in the message being acknowledged. The value of MSH-9-3-
Message structure for the general acknowledgment message is always ACK.
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 and
acknowledgement messages related to those event-triggered messages flow in the other
direction.
350 The acknowledgement message to an event-triggered message shall be sent immediately to

the 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 Actor
application application
Acknowledgement Message Acknowledgement
Message
ORL or ACK OML or OUL ORL or ACK
OML or OUL
Initiates network <SB>message<EB><CR>

connection Initiating Accepting
Sends MLLP block module module
<SB>answer<EB><CR>
Waits for response
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:
Usage of network connections

Trigger events in both Applications
New order Trigger Order status Trigger

entered event event
change
Order Placer Order Filler
ORLÔK OML^NW OML^NW ORLÔK
OML^SC ORLÔK
<SB>OML^NW<EB><CR>
ORLÔK Initiating Accepting OML^SC
module <SB>ORLÔK<EB><CR> module
<SB>OML^SC<EB><CR>
Accepting Initiating
module <SB>ORLÔK<EB><CR> module
370
2.3.6 Identifier Data Types

This section describes the IHE constraints of the data types.
2.3.6.1 EI Data Type

The constraints below particularly apply to the following fields: placer group number, placer
order number, filler order number and specimen number.
SEQ LEN DT Usage CARD TBL# COMPONENT NAME

1 16 ST R [1..1] Entity Identifier
2 20 IS C [0..1] 0363 Namespace ID
3 199 ST C [0..1] Universal ID
4 6 ID C [0..1] 0301 Universal ID Type
Component 1 is required. Either component 2 or both components 3 and 4 are required.

380 Components 2, 3 and 4 may be all present.
The EI is appropriate for machine or software generated identifiers. The generated identifier
goes in the first component. The remaining components, 2 through 4, are known as the
assigning authority; they can also identify the machine/system responsible for generating the
identifier in component 1.
Example 1: AB12345^RiversideHospital
Example 2: AB12345^^1.2.840.45.67ÎSO
Example 3: AB12345^RiversideHospital^1.2.840.45.67ÎSO
IHE restrains the length of the first component to 16 characters. National extensions can
390 extend this length up to a maximum of 199.
IHEr ecomma ndstof illcompone nt2“ Na me spa ceI D”i na llc ases.Pa rt
icul arlywhe nthere
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 the
Order Placer actor operated by the Nephrology department.
ORC|NW|9876543^Nephro||777^Nephro|...
Example 5: Placer order number 9876543 and placer group number 555 assigned by the
400 Order Placer actor operated by the Urology department.
ORC|SC|9876543Ûrology||555Ûrology |...
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 Type

410 The constraints below particurarly apply to the Patient Identifiers (PID segment).
SEQ LEN DT Usage CARD TBL# COMPONENT NAME

1 15 ST R [1..1] ID Number
2 1 ST O [0..1] Check Digit
3 3 ID O [0..1] 0061 Check Digit Scheme
4 227 HD R [1..1] 0363 Assigning Authority
5 5 ID RE [0..1] 0203 Identifier Type Code
6 227 HD O [0..1] Assigning Facility
7 8 DT O [0..1] Effective Date
8 8 DT O [0..1] Expiration Date
9 705 CWE O [0..1] Assigning Jurisdiction
10 705 CWE O [0..1] 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 luesar
ede fine dinTabl e0203ofHL72. 5
section 2.A.14.5.
Example: 12345^^^Saint-John Hospital^PI
3 Common Message Segments for Laboratory Technical

Framework
420 This section describes the common message segments used by the transactions LAB-1, LAB-
2, 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 a
message.
430 Table 3.1-1 : MSH - Message Header
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] 0356 01317 Alternate Character Set Handling
Scheme
21 427 EI RE [0..*] 01598 Message Profile Identifier
MSH-1 Field Separator, required: The IHE Laboratory Technical Framework requires that
applications support HL7-recommended value that is | (ASCII 124).
MSH-2 Encoding Characters, required: This field contains the four characters in the
following order: the component separator, repetition separator, escape character, and
subcomponent separator. The IHE Laboratory Technical Framework requires that
applications support HL7-recommended values ^~\& (ASCII 94, 126, 92, and 38,
respectively).
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 the
sending 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. The name of the organizational entity
responsible for the receiving application.
Second component (optional): The URI (e.g. OID) of the organizational entity responsible for
the 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 the
message. 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 the
sending 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 the
message will be interpreted correctly.
The IHE Laboratory Technical framework requires the first component to be populated with
the value "2.5" representing HL7 release 2.5.
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 table
0211 - 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.
Condition predicate: This field shall only be valued if the message uses a character set other
500 than 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 the
encoding of all of the characters within the message.
MSH-19 Principal Language of Message (CE), required if available. Coded from ISO
639.
Examples: DE = German, EN = English, ES=Spanish, JA = Japanese, FR = French, NL =
Dutch, IT = Italian
MSH-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 for
which 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 is
only allowed in national extensions to this framework.
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

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
5 X [0..0] 00022 Delayed Acknowledgment Type
6 250 CE X [0..0] 0357 00023 Error Condition
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
AA Original mode: Application The message has been accepted and integrated by the receiving
Accept application
AE Original mode: Application Error The sender should try again to send the message later
AR Original mode: Application The message has been rejected by the receiving application
Reject
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
1 493 ELD X [0..0] 00024 Error Code and Location
3 705 CWE R [1..1] 0357 01813 HL7 Error Code
4 2 ID R [1..1] 0516 01814 Severity
Notes: ERR-1 is included in HL7 v2.5 for backward compatibility only. Within the context of the laboratory, this
field shall not be used.
ERR-3 and ERR-4 are required by HL7 v2.5
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
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
550 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 Comment
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 comment
O Other system is the source of the comment
NTE-3 Comment (FT), required but may be empty: This field contains the text of the
comment. This text may be formatted. In order to delete an existing comment, the field shall
cont
ainempt yquot at
ionma rks :“ ”.
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 Used between Automation Manager and Order Filler. Shall
outside of the laboratory not be sent to the Order Result Tracker
C Comment addressed to medical staff and Should be sent to the Order Result Tracker or the Order
physician, Placer, but should not be showed to the patient
P Comment addressed to medical staff and Should be sent to the Order Result Tracker or the Order
physician, may be showed to the patient Placer, and may appear on the result report addressed to the
patient.
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 and
demographic information that, for the most part, is not likely to change frequently.
Table 3.5-1 : PID - Patient Identification segment
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
her
’sMa
ide
nNa
me
7 26 TS RE [0..1] 00110 Date/Time of Birth
8 1 IS R [1..1] 0001 00111 Administrative Sex
9 250 XPN X [0..1] 00112 Patient Alias
10 250 CE RE [0..1] 0005 00113 Race
11 250 XAD RE [0..*] 00114 Patient Address
12 4 IS X [0..1] 0289 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] 0189 00125 Ethnic Group
23 250 ST O [0..1] 00126 Birth Place
24 1 ID O [0..1] 0136 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
570 The specific usage of these fields, especially those fields with usage " O " (optional) in the
table above, is explained in the national extensions.
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 (PV1-
19). 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 to
communicate information on an account or visit-specific basis.
Table 3.6-1: PV1 - Patient Visit segment
2 1 IS R [1..1] 0004 00132 Patient Class
3 80 PL RE [0..1] 00133 Assigned Patient Location
9 250 XCN X [0..0] 0010 00139 Consulting Doctor
19 250 CX RE [0..1] 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
The specific usage of these fields may be elaborated upon in the national extensions.
The use of the Visit Number (PV1-19) may be related to the Patient Account Number (PID-
18). 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
590 Framework.
Field PV1-51 shall be valued with value 'V' if the field PV1-19 is present. The field may be
omitted otherwise.
ThePV1s eg me ntdoe sn’ tenti
rel
yc ove rtheda tamode la sdefinedi nt hi
sframe wor
k.I n
some countries (especially in Europe), national extensions will define new segment to
manageissue sli
ke‘ functionalunits
’.
The use of the PV1 segment shall be clarified in each national extension.
3.7 ORC Common Order Segment

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
600 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

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] 0038 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] 0339 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] 0552 01641 Advanced Beneficiary Notice Override
Reason
27 26 TS C [0..1] 01642 Filler's Expected Availability
Date/Time
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 “New Or der” .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 “Notif
icat
ionorr
eque
sta
cce
pte
d”.Ev
entn
oti
fi
cat
ioni
nOMLme
ssa
ge.Ev
enta
cknowl
edg
eme
nti
nORL
message
UA “Una blet oa cceptor der/
s er
v ice ”. Ev entnot i
fi
cat
ioni nOML me ssage.Ev enta cknowledgeme ntinORL
message sent by the Order Filler in transaction LAB-1 or in ORL message sent by the Automation Manager in
transaction LAB-4.
SC “
Sta
tusc
hang
ed”
.Ev
entnotification in OML and OUL messages
CA “Canc elor de r/ser
vic
er e
que
st”
.Ev
entr
eque
sti
nOMLme
ssa
ges
entbyt
heOr
derPl
ace
rinLAB-1, or by the
Order Filler in LAB-4.
CR “
Canc
ele
dasr
eque
ste
d”.Ev
enta
cknowl
edg
eme
nti
nORLme
ssa
ger
espond
ingt
oOML(
CA)
UC “
Una
blet
oca
nce
l”.Ev
enta
ckno
wle
dge
menti
nORLme
ssa
ger
espon
dingt
oOML(
CA)
Value Description of use

OC “Orderser
v ic
eca
nce
led”
.Ev
entnot
if
ica
tioni
nOMLme
ssa
ges
entbyt
heOr
derFi
ll
eri
ntr
ans
act
ionsLAB-1
and LAB-3.
SN “
Sendor
der
/se
rvi
cenumbe
r”.Eve
ntr
eque
stin OML message sent by the Order Filler in transaction LAB-2
NA “Numbera ss
i g
ned”
.Ev
enta
ckno
wle
dge
menti
nORLme
ssa
ges
entbyt
heOr
derPl
ace
rinLAB-2, responding
to OML (SN)
RP “Or der/
ser
vic
er epl
a cere que st
”.Ev entre que sti nOMLme ss
agese ntbyt
he Order Placer in transaction LAB-1
or in OML message sent by the Order Filler in transaction LAB-4.
RQ “
Repl
ace
dasr
eque
ste
d”.Ev
enta
cknowl
edg
eme
nti
nORLme
ssa
ger
espond
ingt
oOML(
RQ)
UM “
Una
blet
ore
pla
ce”
.Ev
enta
cknowl
edge
menti
nORLme
ssa
ger
esponding to OML (RQ)
RU “Replace duns ol
ici
ted”
.Ev
entno
tif
ica
tioni
nOMLme
ssa
ge(
LAB-1) and OUL message (LAB-3) sent by the
Order Filler.
XO “
Cha
ngeor
der
/se
rvi
cer
eque
st”
.Us
edbyt
heOr
derPl
ace
rinLAB-1
XR “
Cha
nge
dasr
eque
ste
d”.Us
edbyt
heOr
derFiller in LAB-1 in response to XO
UX “
Una
blet
ocha
nge
”Us
edbyt
heOr
derFi
ll
eri
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.
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 refer
620 to 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
A Some, but not all, results available
CA Order was canceled
CM Order is completed
IP In process, unspecified
SC In process, scheduled
630
Note: For the conditions of use of these values, please read section 3.12 “
Cor
rel
ati
onsofst
atusbet
ween
ORC,OBRandOBX” .
ORC-9 Date/Time of Transaction (TS), required

HL7 Definition: This field contains the date and time of the event that initiated the
current 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 the
640 physical message.
In OML messages "Status changed" sent by the Order Filler, this field contains the
date/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 to
match the value of the required field OBR-16.
This field contains the person (physician) who prescribed this order. See the data model in
volume 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 lued:1s t=Or ga niza ti
onna me .7t h=I dentifi
e rTy peCodewhi ththevalue“ FI”,
whic hme a ns“Fa l
ilityI D”a ss tatedbyHL7t ablen°0203.10t h=Or g a
ni za
tionI
den tif
ier.
Example: Urology^^^^^^FI^^ÛR01
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
Filler
660
3.8 TQ1 - Timing Quantity Segment

HL7 v2.5: chapter 4 (4.5.4)
Table 3.8-1: TQ1 - Timing Quantity Segment
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
S Stat With highest priority
A ASAP Fill after S orders
R Routine Default
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> Timing critical within <integer> months.
PRN As needed
670 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 be
filled.
3.9 SPM - Specimen Segment

HL7 v2.5: chapter 7 (7.4.3)
680 Table 3.9-1: SPM - Specimen Segment
2 80 EIP C [0..1] 01755 Specimen ID
3 80 EIP RE [0..*] 01756 Specimen Parent IDs
4 250 CWE RE [1..1] 0487 01900 Specimen Type
8 250 CWE C [0..1] 01901 Specimen Source Site
9 250 CWE C [0..*] 0542 01760 Specimen Source Site Modifier
11 250 CWE RE [0..*] 0369 01762 Specimen Role
16 250 CWE RE [0..1] 0489 01903 Specimen Risk Code
17 26 DR RE [0..1] 01765 Specimen Collection Date/Time
18 26 TS C [0..1] 00248 Specimen Received Date/Time
20 1 ID C [0..1] 0136 01766 Specimen Availability
21 250 CWE C [0..*] 0490 01767 Specimen Reject Reason
26 4 NM RE [0..1] 01772 Number of Specimen Containers
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 LAB-
1, 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) in
transactions 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 for
the details of the data type.
This version of IHE Laboratory Technical Framework does not admit pooling of
specimens; 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.
The authorized values for this field are those of HL7 table 0487 - Specimen type. See
HL7v2. 5c ha pter7( 7.18.4)
.HL7doe sn’ts uggestva l
uesf orta ble0487.Thef ol
lowi
ng
700 table, which is a subset of HL7 table 0070, provides some values as an example.

ABS Abscess
AMN Amniotic fluid
ASP Aspirate

BIFL 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 Cannula
CTP Catheter tip
CSF Cerebral spinal fluid
CVM Cervical mucus
CVX Cervix
COL 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)
ELT Electrode
ENDC Endocardium
ENDM Endometrium
EYE Eye
EXG Exhaled gas (=breath)
FLT Filter
FIST Fistula
FLU Body fluid, unsp
GAS Gas
GAST Gastric fluid/contents
GEN Genital
GENC Genital cervix
GENL Genital lochia

GENV Genital vaginal
HAR Hair
IHG Inhaled Gas
IT Intubation tube
ISLT Isolate
LAM Lamella
LN Line
LNA Line arterial
LNV Line venous
LIQ Liquid NOS
MAR Marrow
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 Plasma
PLB Plasma bag
PLR Pleural fluid (thoracentesis fld)
PPP Platelet poor plasma
PRP Platelet rich plasma
PUS Pus
RT Route of medicine
SAL Saliva
SMN Seminal fluid
SER Serum
SKN Skin
SKM Skeletal muscle
SPRM Spermatozoa
SPT Sputum
SPTC Sputum - coughed
SPTT Sputum - tracheal aspirate
STL Stool = Fecal
SWT Sweat
SNV Synovial fluid (Joint fluid)

TEAR 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
SPM-8 Specimen Source Site (CWE), conditional.

Condition predicate: This field should be populated by the placer in microbiology, when the
spe
cime nsources iteisknown.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 the
specimen source sitemodi f
ierisknown.Exa mpl e:“ LEFT”whe nt hes pecimenha sbe en
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.
User-defined Table 0369 - Specimen Role

B Blind Sample
C Calibrator, used for initial setting of calibration
E Electronic QC, used with manufactured reference
providing signals that simulate QC results
F Specimen used for testing proficiency of the
organization performing the testing (Filler)
G Group (where a specimen consists of multiple
individual elements that are not individually
identified)
L Pool (aliquots of individual specimens combined to
form a single specimen representing all of the
components.)
O Specimen used for testing Operator Proficiency
P Patient
Q Control specimen
R Replicate
V Verifying Calibrator, used for periodic calibration
checks
SPM-16 Specimen Risk Code (CWE), required if available.

This field contains any known or suspected specimen hazards. The authorized values for
this field are those of HL7 table 0489 - Risk Codes. See HL7 v2.5 chapter 7 (7.4.3.16).
Condition predicate: This field shall be populated if known in OML messages sent
by 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 user-
720 defined table 0489:
User-defined Table 0489 –Risk Codes
Code Description Comment/Usage Note/Definition
BIO Biological The dangers associated with normal biological materials. I.e. potential
risk of unknown infections. Routine biological materials from living
subjects.
COR Corrosive Material is corrosive and may cause severe injury to skin, mucous
membranes and eyes. Avoid any unprotected contact.
ESC Escape Risk The entity is at risk for escaping from containment or control.
AGG Aggressive A danger that can be associated with certain living subjects, including
humans.
IFL MaterialDangerInflammable Material is highly inflammable and in certain mixtures (with air) may
lead to explosions. Keep away from fire, sparks and excessive heat.
EXP Explosive Material is an explosive mixture. Keep away from fire, sparks, and
heat.
INF MaterialDangerInfectious Material known to be infectious with human pathogenic
microorganisms. Those who handle this material must take
precautions for their protection.
BHZ Biohazard Material contains microorganisms that are an environmental hazard.
Must be handled with special care.
INJ Injury Hazard Material is solid and sharp (e.g., cannulas.) Dispose in hard container.
POI Poison Material is poisonous to humans and/or animals. Special care must be
taken to avoid incorporation, even of small amounts.
RAD Radioactive Material is a source for ionizing radiation and must be handled with
special care to avoid injury of those who handle it and to avoid
environmental hazards.
SPM-17 Specimen Collection Date/Time (DR), required if available.
Definition: The date and time when the specimen was acquired from the source. The use
of the Date Range data type allows for description of specimens collected over a period of
time, 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 in
both 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 an
analysis. The two authorized values are "Y" (yes) or "N" (no).
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
740 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=‘ IP’i mpl ici
tlyme anst hatt 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
EX Expired
QS Quantity not sufficient
RB broken container
RC Clotting
RD missing collection date
R missing patient ID number
RE missing patient name
RH Hemolysis
RI Identification problem
RL Improper labeling
RM labeling
RN contamination
RP missing phlebotomist ID
RR improper storage
RS name misspelling
750 SPM-26 Number of Specimen Containers (NM), required if available.
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 specimens
that 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 all
other fields to be optionally used.
Table 3.10-1 : SAC Segment
3 80 EI R [1..1] 01331 Container Identifier
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 OMLÔ21, ORLÔ22, OMLÔ33,
ORLÔ34: 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 number
of specimens (e.g. a specimen is split between several containers) or if the container identifier
differs 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 identifier
assigned by the corresponding equipment. A container may contain the primary (original)
specimen or an aliquot (secondary sample) of that specimen. For primary sample this
field contains Primary Container ID; for bar-coded aliquot samples this field contains
Aliquot Container ID.
SAC-4 –Primary (parent) Container Identifier (EI), conditional.

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
780 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.
3.11 OBX - Observation/Result Segment

HL7 v2.5: chapter 7 (7.4.2)
Table 3.11-1 : OBX Segment
1 4 SI R [1..1] 00569 Set ID –OBX
2 2 ID C [0..1] 0125 00570 Value Type
3 250 CE R [1..1] 00571 Observation Identifier
4 20 ST C [0..1] 00572 Observation Sub-ID
5 99999 Varies C [0..1] 00573 Observation Value
6 250 CE C [0..1] 00574 Units
7 60 ST RE [0..1] 00575 References Range
8 5 IS RE [0..1] 0078 00576 Abnormal Flags
9 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
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 be
used 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 a
time measurement (e.g. bleeding time) the TM Value Type is preferred to NM but this is not
made 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 .
i
The first and third sub-fel
ds“
Ide
nti
fi
er”
,and“NameofCodingSys
tem”ar
erequi
redi
nal
l
t
ransa ctions.Theva l
ueofthe“
NameofCodingSy
ste
m”inthecas
eofLOINCis“LN”.
In transaction LAB-3 the second sub-f iel

d“ Text”i sma nda t
ory ,whi c ha
llowst
heOr
der
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 segments
with 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 (OBX-
11) 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". If
valued, 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 is
relevant. The References range that figures in this field is supposed to be related to age and
sex of the patient or to other parameters such as number of weeks of pregnancy when
applicable, 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
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.
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 numeric
value 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 the
value 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 a
subset of this table:
Table 3.11-3 : HL7 Table 0085
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 to
cancel a false result transmitted in a former message, in the
situation 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 a Can only be changed with a corrected result.
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 and This status may be used only after an ‘
F’ora‘
C’s
tat
us.
thus replaces a final result
X Results cannot be obtained for this Tests that have this status have to be shown to the user.
observation
Correlations of status between
ORC,OBRandOBX” .
850 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 result
with its associated reference range.
OBX-13 User Defined Access Checks (ST), conditional.
Condition predicate: In transaction LAB-3, the Order Filler should value this field with a "P"
860 when it wants to inform the Order Result Tracker of restricted access on some results to
privileged 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 is
transmitted in a reference lab and observation date and time is not returned together with the
result), 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 the
identity of the observer that causes the change of the observation result status. Only the first
component (ID number) of this field is necessary, provided that it is possible to retrieve the
full 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
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, the
OBR-25 (Order Result Status) field and the OBX.11 (Observation Result Status) field. OBX-
11 contains the status of an individual test, OBR-25 the status of the entire request.
Summary of the 3 relevant reference tables:
Order Request Result Description (combined from 3 tables)
Table 0038 Table 0123 Table 0085
(ORC-5) (OBR-25) (OBX-11)
O O 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.
SC S No results available; procedure scheduled, but not done.
The specimen may not have arrived at the laboratory. No OBX is
present
IP I I In process; The specimen is available in the laboratory; results are
pending; the procedure is incomplete
D Deletes the OBX record
A R R (Some) results entered -- not yet verified
A 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 a
corrected 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-5arel
ess‘
atomic’tha
nt hos eus edi nOBR-25/OBX-11. If
thereisnodi rect‘sema nti
cma t
ch’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 by
these fields. Please note that this table does not identify all possible relationships of the
various status fields. The relationship between the various status fields are described below.
3.12.2 Status transition diagrams
3.12.2.1 ORC-5: Order status

The status fields of an order and the associated result express the status of the order and result
910 as they are processed and finalized. The transition of the coded values used in the status fields
is shown below:
SC: In process, scheduled,
IP specimen may not be available
yet
SC IP: In process, specimen available
A in laboratory
CM A: Some but not all results
available
CM: Order is completed
CA: Order canceled (at any stage
CA of the process)
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, the
initial 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 of
processing.
920
3.12.2.2 OBR-25: Order Result status
O: Order received. Specimen not yet received

I R S: Scheduled, specimen may not be available
C yet
I: Specimen available, results pending
S P R: Some results available, not verified, i.e.
O F not technically (LAB-5) or clinically (LAB-3)
validated
P: Preliminary (partial) results verified, i.e.
technically (LAB-5) or clinically (LAB-3)
X 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 the
process)
Figure 3.12.2.2-1: The OBR-25 status transition diagram
initial 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
930 code equals P, the next status code could be either F or P. If the status code equals F, the next
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
O: Order detail description only. No result

R I: Specimen in lab, results pending
I C R: Result entered, not verified, i.e. not
P validated
O F P: Preliminary (partial) result verified, i.e.
validated
F: Final result verified, i.e. technically
X D (LAB-5) or clinically (LAB-3) validated
C: Correction after final result. Result still
final and verified.
X: Result cannot be obtained for this
observation
D: Deletes the OBX record
940 Figure 3.12.2.3-1: The OBX-11 status transition diagram
initial 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 code
equals 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-25fie
ldcannotbe“hi
ghe
r/morefi
nali
zed”t han
the“lowe st”s t
atusofa nyoft herel
atedi
ndivi
dualt
est
s(asc
ont
aine
di nOBX-11). For
example: OBR-25c a nonlybe‘ F’(
Final
)whenallre
lat
edOBX-11fiel
dscont
ain‘ F’.
2. Thes t
atusoft heordera sdefi
nedbyt heOrderFul
fi
ll
erc annotbe“higher/more
fi
nali
zed”t hanthes t
atusoft her e
lat
edre
quest(asconta
inedi n OBR-25). For
example: ORC-5 can only be‘CM’( Complet
e)whent her e
lat
ed OBR-25 field
cont
ains‘F’(Fi
nal)or‘C’(Correc
ted)
.
3. Fort hepur posesofde termi ningwhi chs t
a t
usi
s“hi
ghe
r/mor efinal
ized”,anyOBX-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
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 order
is prescribed by a physician and/or ordered by a care unit, and is performed by a clinical
laboratory. 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, the
laboratory collects and identifies them. In both cases, the laboratory is responsible for
obtaining and managing valid specimens for the ordered batteries, in conformity with good
laboratory 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 by
transaction LAB-2.
The main goal of the Placer Order Management Transaction is to allow consistent
980 management of the content and status of the order between the Order Placer and Order Filler
actors.
4.2 Use Case Roles
Placer Order Mgt
Actor :Order Placer

Roles : Places orders. Updates orders. Cancels orders. Nullifies orders. Receives acceptance
or 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.
4.3 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
 Chapter 7: "Observation Reporting" --> SPM segment
1000  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: OMLÔ21  ORLÔ22
OMLÔ33  ORLÔ34
OMLÔ35  ORLÔ36
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 a
communication system. The message broker (an intermediary between the Order Placer and
theOr derFi ller)ha snoknowl edgeoft
het estsbe ingr equest
edandcan’ta ccept
/r
eje
ctthese
test on behalf of the Order Filler.
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, from
placing of the order by the Order Placer, to the "order completed" event notified by the 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 the
related 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
Replacement
of 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.
4.4.2 Cancellation of an order by the Order Placer
Placer order
cancelled
OML Cancel order request: ORC-1 = CA For each battery, the cancel
request is accepted or
refused (if the processing has
ORL acknowledgement already started)
Cancelled as requested: ORC-1 = CR
Unable to cancel: ORC-1 = UC
Figure 4.4-2: Cancellation of an order by the Order Placer
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
1030 LAB-4).
4.4.3 Cancellation of an order initiated by the Order Filler
Cancellation of
the order
OML Order cancelled: ORC-1 = CO initiated by the
laboratory
ORL acknowledgement ORC-1 = OK
Figure 4.4-3: Cancellation by Order Filler
4.5 Messages static definitions
4.5.1 Available HL7 2.5 structures for OML message

1040 HL7 v2.5 chapter 4, offers three different message structures for the OML message type :
  OMLÔ21ÔML_O21: laboratory order message. This is a battery-centric
structure: It contains a list of ordered batteries, a list of specimens underneath each
battery, 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).
  OMLÔ33ÔML_O33: Laboratory order for multiple orders related to a single
specimen. This is a specimen-centric structure providing for each specimen a list of
containers and a list of batteries (ORC/OBR segment groups) using this specimen.
1050 The batteries are not related to the containers.
  OMLÔ35ÔML_O35: Laboratory order for multiple orders related to a single
container of a specimen. This message structure provides for each specimen a list of
containers, 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 by
container.
4.5.2 Restrictions on OML message for transaction LAB-1

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,
1060 therapy, diagnosis, temperature, urine volume, blood pressure, within observation
segments (OBX) that accompany the order. This choice has been made to simplify the
building and parsing of the messages. All these specific patient observations are sent
in 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 the
segment TQ1 is the specimen collection. In this Laboratory Integration Profile this
operation 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
1070 orders sent to laboratories require one single execution, even the studies based on a
temporal series of specimens. For example a serum glucose tolerance study is an
atomic order to be performed once, taking into account all the specimens to be tested.
4.5.3 OMLÔ21 static definition

Table 4.5-1: OMLÔ21 static definition for transaction LAB-1
[ --- PATIENT begin O [0..1]
[ PV1 ] Patient Visit RE [0..1] 3
] --- PATIENT end
{ --- ORDER begin R [1..*]
ORC Common Order (for one battery) R [1..1] 4
[{TQ1}] Timing Quantity RE [0..1] 4
[ --- OBSERVATION REQUEST begin R [1..1]
OBR Observation Request R [1..1] 4
{[NTE]} Notes and Comments O [0..*] 2
[{ --- OBSERVATION begin O [0..*]
OBX Observation Result R [1..1] 7
[{NTE}] Comment of the result C [0..*] 2
}] --- OBSERVATION end
[{ --- SPECIMEN begin O [0..*]
SPM Specimen R [1..1] 7
[{SAC}] Container C [2..*] 13
}] --- SPECIMEN end
[{ --- PRIOR_RESULT begin O [0..*]
PV1 Patient Visit –previous result RE [0..1] 3
{ --- ORDER_PRIOR begin R [1..*]
[ORC] Common Order - previous result O [0..1] 4
OBR Order Detail - previous result R [1..1] 4
{[NTE]} Notes and Comments - previous result O [0..*] 2
{ --- OBSERVATION_PRIOR begin R [1..*]
OBX Observation/Result - previous result R [1..1] 7
} --- OBSERVATION_PRIOR end
} --- ORDER_PRIOR end
]} --- 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 is
repeated 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
derer(
pat
ientt
empe
rat
ure,bloodpr ess
ure,we ight
,…) ,wi theventualc omme nt
s( NTE) .
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 the
laboratory 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 in
section 3.10.
Condition predicate for the NTE segment below OBX (Comment of the result): Information
that can be coded in OBX segments or OBR segments shall not be sent in a NTE segment.
1090 4.5.4 ORLÔ22 static definition

Table 4.5-2 : ORLÔ22 Message
MSH Message header R [1..1] 2
[{ERR}] Error C [0..*] 2
[PID] Patient Identification O [0..1] 3
ORC Common Order R [1..*] 4
[{TQ1}] Timing/Quantity RE [0..1] 4
[{ --- SPECIMEN begin O [0..1]
[{SAC}] Specimen Container Details O [0..*] 7
}] --- SPECIMEN 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).
4.5.5 OMLÔ33 static definition

Table 4.5-3: OMLÔ33
Segment Meaning Usage Card. HL7
] --- PATIENT end
{ --- SPECIMEN begin R [1..*]
SPM Specimen R [1..*] 7
[{SAC}] Specimen Container C [2..*] 13
ORC Common Order (for one battery) R [1..*] 4
[{NTE}] Notes and comments for result C [0..1]
{ --- PRIOR RESULT begin O [0..*]
{ --- ORDER PRIOR begin R [1*]
[ORC] Common order –previous result O [0..1] 4
OBR Order detail –previous result R [1..1] 4
{ --- OBSERVATION PRIOR begin R [1..*]
OBX Observation/Result –previous result R [1..1]
} --- OBSERVATION PRIOR end
} --- ORDER PRIOR end
} --- PRIOR RESULT end
} --- ORDER end
} --- SPECIMEN end
1100 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 OMLÔ21.
The condition and cardinalities on the SAC segment are the same as for OMLÔ21.
4.5.6 ORLÔ34 static definition

Table 4.5-4: ORLÔ34
[{ERR}] Error O [0..*] 2
[{SAC}] Specimen Container O [0..*] 13
[{ --- ORDER begin O [0..*]
ORC Common Order R [1..1] 4
[OBR] Observation Request R [1..1] 4
}] --- ORDER end
} --- SPECIMEN end
“
1110 4.5.7 OMLÔ35 static definition

Table 4.5-5 : OMLÔ35 static definition for transaction LAB-1
Segment Meaning Usage Card HL7
] --- PATIENT end
{ --- CONTAINER begin R [1..*]
SAC Container detail R [1..1] 13
OBX Observation Result R [1..*] 7
[{ --- PRIOR_RESULT begin O [0..*]
{ --- ORDER_PRIOR begin R [1..*]
[ORC] Common Order - previous result R [1..1] 4
OBR Order Detail - previous result R [1..1] 4
{ --- OBSERVATION_PRIOR begin R [1..*]
OBX Observation/Result - previous result R [1..1] 7
} --- OBSERVATION_PRIOR end
} --- ORDER_PRIOR end
}] --- PRIOR_RESULT end
} --- ORDER end
} --- CONTAINER end
} --- SPECIMEN end
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
OMLÔ21.
The SAC segment below the SPM segment is mandatory in OMLÔ35 message structure.
4.5.8 ORLÔ36 static definition

Table 4.5-6 : ORLÔ36
[{ERR}] Error O [0..*] 2
{ --- SPECIMEN begin
SPM Specimen R [1..*] 7
SAC Specimen Container R [0..*] 13
[{ --- ORDER begin R [1..*]
}] --- ORDER end
} --- CONTAINER end
} --- SPECIMEN end
1120
“
The SAC segment below the SPM is mandatory in ORLÔ36 message structure.
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
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 RE [0..*] 00244 Collector Identifier *
11 1 ID RE [0..1] 0065 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 *
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 +
28 250 XCN C [0..*] 00260 Result Copies To
29 200 EIP X [0..0] 00261 Parent
30 20 ID X [0..0] 0124 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] 0476 01646 Medically Necessary Duplicate
Procedure Reason.
1130
OBR-2 Placer Order Number (EI), required in transaction LAB-1.
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.
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
1140 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.
a
This repeatbl
efi
eldc
ont
ainst
hes
pec
ime
ncol
lec
tor
s’i
dent
if
ica
tion.
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) the
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 4.5-8 : HL7 Table 0065 - Specimen Action Code
A Add ordered tests to the existing specimen
G Generated order; reflex order
L Lab to obtain specimen from patient
O Specimen obtained by service other than Lab
P Pending specimen; Order sent prior to delivery
R Revised order
S Schedule the tests specified below
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.
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 the
date/time of the latest status change of the ORDER.
OBR-24 Diagnostic Serv Sect ID (ID), conditional
Condition predicate: This field may be valued in OML messages sent by the Order Filler. In
1170 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 Chemistry Yes
CP 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, the
possible values for this field are a subset of this table:
HL7 Table 0123 - Result Status
O Order received; specimen not yet received
I No results available; specimen received, procedure

incomplete
S 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 obtained
F Final results; results stored and verified. Can only be

changed with a corrected result.
C Correction to results
X No results available. Order canceled
1180
Cor
rel
ati
onsofst
atusbet
ween
ORC,OBRandOBX” .
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.
5 Transaction LAB-2: Filler Order Management
5.1 Scope
1190 This transacti
oni sus edbyt hege ne r
alus ec ase“ Filler order with specimens identified by
third party or collected by the laboratory”de scri
be di nt heVol ume1oft histe chnical
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 collected
from the subject. A battery contains one or more tests, each of which may produce one or
more observations.
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
1200 actors.
5.2 Use Case Roles
Filler Order Mgt
Actor :Order Placer

Roles : Receives filler orders. Notifies the Order Filler of acceptance or refusal. Notifies the
Order Filler of the placer order number if the filler order was accepted.
Actor :Order Filler
Roles : Places filler orders by sending them to the Order Placer. Receives acceptance or
1210 rejection 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.

HL7 version 2.5:
 Chapter 3: "ADT" --> PID and PV1 segments
 Chapter 4: "Order Entry" --> OML and ORL messages

Chapter 7: "Observation Reporting" --> SPM segment
1220 
Chapter 13: "Clinical Laboratory Automation" --> SAC segment

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: OMLÔ21  ORLÔ22
OMLÔ33  ORLÔ34
OMLÔ35  ORLÔ36
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)
hasnoknowl edgeoft het e
stsbeingreque steda ndc an’tassigni de ntifi
ca t
ionnumb e r
son
behalf 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.
Note that the creation of a filler order may be triggered by a prior placer order, e.g. if the
results of one of the previously ordered tests triggers the laboratory to perform additional
1240 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 decide
that some extra battery that was not ordered should be added, e.g. regarding the pathology
context.
Creation of a
For each battery, the
filler order is accepted new filler order
OML Send order/service number: ORC-1 = SN
or rejected. In case of
acceptance the Placer
Order is reported to ORL acknowledgement
the Order Filler. Number assigned: ORC-1 = NA
Unable to accept order: ORC-1 = UA
Figure 5.4-1: Process of a filler order
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

This cycle of Laboratory Technical Framework supports multiple message structures as
defined above, and makes the following restrictions for transaction LAB-2:
Re str
ictst i
mi ng/
qua ntit
yt oonei nstanc epe ror de r(i.
e .there’sonei te
rat
ionoft 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
1260 Technical Framework. The collection process is part of either the Order Placer or the
Order 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

2 22 EI X [0..0] 00216 Placer Order Number
3 22 EI R [1..1] 00217 Filler Order Number
10 250 XCN RE [0..*] 00244 Collector Identifier *
12 250 CE X [0..0] 00246 Danger Code
16 250 XCN RE [0..1] 00226 Ordering Provider
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 +
24 10 ID RE [0..1] 0074 00257 Diagnostic Serv Sect ID
25 1 ID X [0..0] 0123 00258 Result Status +
28 250 XCN C [0..*] 00260 Result Copies To
29 200 EIP X [0..0] 00261 Parent
Procedure Reason.
1270
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 to
section 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 across
all 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
1280 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 for fields that supersedes them.
OBR-10 Collector Identifier, required if available.
Thi
sre
pea
tabl
efi
eldc
ont
ainst
hes
pec
ime
ncol
lec
tor
s’i
dent
if
ica
tion.
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
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
G 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 clinical
information, 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 table
below 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 Chemistry Yes
CP 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.

HL7 Definition: This field identifies the persons who are to receive copies of the results. By
1310 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 of
results related to this order, they should be listed here.
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 Scope
This transaction notifies the Order Result Tracker of requested tests upon creation of an order
1320 or reception of a specimen in the laboratory. It transmits the observation results from the
Order 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 the
Order Result Tracker with the complete sorted set of results related to a placer order or a
placer 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 of
transaction 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 specific
preparation.
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 of
technically 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 a
placer order group.
Actor: Order Result Tracker

Roles: Receives test order and results from the Order Filler, gives access to this order and
1340 results to the healthcare enterprise, respects the sorting order of the results as received from
the Order Filler.

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
hasc ho senHL7" OUL"me ssagesins t
ea dof“ORU” .
HL7 version 2.5:

1350  Chapter 3: "Patient Administration" --> PID and PV1 segments
 Chapter 4: "Order Entry" --> OBR segment
 Chapter 7: "Observation Reporting" --> OUL messages
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 the
completion 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 the
OBR (OBR-25) is indicated.
Ord er Filler Order R esult

Tracker
New order received

or generated
OUL, Result status S
ACK, (applicative acknowledgement )

Reception and
acceptance of
specimen OUL, Result status I
Technically validated
results available OUL, Result status R
Clinical validation
of results OUL, Result status P (partial) or F (final)
Correction of
results previously OUL, Result status C
sent as clinically
validated ACK, (applicative acknowledgement )
1360
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
ult
Status”“ R” )t ot heOr derRe sultTrac keri sdr i
venbyor ga ni
za t
ionr ul e
ss pe ci
fict oe ach
healthcare enterprise. These rules may take account of the order priority (TQ1-9), the
ordering provider, the particular ordered battery, the executing laboratory, the observation
resultitself… TheI HE La bor at
oryTe c hnica lFr
ame workdoe snotma kea nya ssertionon
these rules. It only states that an Order Filler MUST be able to send all the result statuses
mentioned in the above diagram, and doing so, MUST conform to the correlation diagrams
and transition diagrams presented in section 3.12.
1370 The same remark applies to the sending of partial clinically validated results (using OBR-25
“ResultStatus
”“ 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 be
deleted from the filler order, which should trigger a message to the Order Result Tracker as
shown below.
Figure 6.4-2: Deletion of a test by Order Filler
6.4.3 Addition of Battery/Test in a filler order

1380 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 as
shown below.
Figure 6.4-3: Addition of a test by Order Filler
6.5.1 OUL : Unsolicited Laboratory Observation message

The following events from an Order Filler (LIS) will trigger an Unsolicited Laboratory
Observation (OUL) message to the Order Result Tracker:
1390 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

Clinical validation of results

Modification of already transmitted results

Cancellation of results

Addition/Deletion of tests
Among the different types of OUL messages that are described in HL7 Chapter 7, two
different types of OUL messages should be considered depending on the specialty of the
1400 laboratory 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).
In both message structures the order in which the OBX segments appear defines the
sorting order for the presentation of the results for a given battery or specimen. In this
1410 respect, 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
] --- PATIENT end
[{ --- SPECIMEN begin R [1..*]
[{OBX}] Observation related to specimen O [0..*]
[{ --- ORDER begin R [1..*]
OBR Observation Request R [1..*] 4
[ORC] Common Order (for one specimen) R [1..1] 4
[{ --- RESULT begin O [0..*]
OBX Observation related to OBR R [1..*] 7
}] --- RESULT end
}] --- ORDER end
}] --- SPECIMEN end
Field MSH-9 – Message Type shall have its three components valued as follows:
OUL^R22ÔUL_R22
For specimen oriented observation message, additional parameters that are related to the
specimen (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 all
observations 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 information
such 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
] --- PATIENT end
[ORC] Common Order (for one battery) R [1..1] 4
[{ --- SPECIMEN begin O [0..*]
[{OBX}] Observation related to specimen O [0..*]
}] --- SPECIMEN end
[{ --- RESULT begin R [1..*]
OBX Observation related to OBR R [1..1] 7
}] --- RESULT end
} --- ORDER end
OUL^R24ÔUL_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.
Although in most of cases there is only one specimen related to the OBR segment, for
1450 batteries 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 the
last specimen.
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 all
observations 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
1460 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 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.
TQ1 and ORC segments shall be transmitted because they contain important information
1470 such 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 as
requested 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 this
specimen. 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
2 22 EI RE [0..1] 00216 Placer Order Number
3 22 EI R [1..1] 00217 Filler Order Number
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..1] 00244 Collector Identifier
11 1 ID C [0..1] 0065 00245 Specimen Action Code
12 250 CE X [0..0] 00246 Danger Code
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
28 250 XCN RE [0..*] 00260 Result Copies To
29 200 EIP X [0..0] 00261 Parent
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
38 250 CE X [0..0] 01029 Transport Logistics of Collected Sample
39 250 CE X [0..0] 01030 Collector's 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 Service
Information
47 250 CE X [0..0] 0411 01475 Filler Supplemental Service Information
Procedure Reason.
49 2 IS X [0..0] N 01647 Result Handling
1480
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 details
of the data type. In case of a Filler Order, the value of this field will be known to the
sender 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 a
request 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
i
The first three sub-fel
ds“
Ide
nti
fi
er”
,“Te
xt”a
nd“
NameofCodi
ngSy
ste
m”a
rer
equi
red.
The second sub-f ield“ Text”a ll
owst heOr
derRe
sul
tTr
acke
rtoma
naget
her
esul
ts
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 performed
at 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 the
result 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 be
transferred 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)
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 of
1510 Laboratory 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 a
diagnostic (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)
Since it is stated in the HL7 V2.5 Chapter 7 that "for some orders this information may be
sent 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 to
1520 systematically use OBX segments in OUL message for sending Clinical Information.
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)
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 for
this field are:
 Value I is used to indicate reception of specimen(s) at the laboratory. In case a
battery 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
1540 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 of
collected 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 have
been 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
1550 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 transmitted
with 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 when
the 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
1560 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 Query
message. It can be used in OUL messages for tests that have been added to the
original request by the Order Filler (LIS). In this case, the value of the OBR-11
field (Action Code) should be either A, or G.
Cor
rel
ati
onsofst
atusbet
ween
ORC,OBRandOBX” .
OBR-28 Result Copies To (XCN)

This field may be used to indicate the list of recipients who will receive a hard copy of the
1570 results 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 the
results, where, and when this clinical validation was performed. It describes completely
the“ Cl ini
calVa l
ida t
ion”ste
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 logical
acknowledgement message from the Order Result Tracker to the Order Filler. This General
Acknowledgement Message‘ ACK’s hallbebui l
ta ccordingt oHL7V2. 5s t
a nda rd.
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

Manager
Work Order Mgt
Actor: Order Filler

The role: manages orders and takes care of the routing to the appropriate Automation
1610 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.

HL7 version 2.5 Chapter 4
ORL messages SHALL be created by the Automation Manager application, and not by a
1620 message broker. The message broker (an intermediary between the Order Filler and the
Automation Manager) has no knowledge of the tests being requested a
ndc
an’
ta c cept
/rej
ect
these test on behalf of the Automation Manager.

Manager
OMLÔ21, O33, O35

New Order (ORC-1: NW)
ORLÔ22, O34, O36
Order accepted (ORC-1: OK)
Unable to accept (ORC-1: UA)
OMLÔ21, O33, O35

Order Modify (ORC-1: RP)
ORLÔ22, O34, O36
Order modified
OMLÔ21, O33, O35

Order Cancel (ORC-1: CA)
ORLÔ22, O34, O36

Order cancelled
Figure 7.4-1: Normal process of ordering to Automation Manager
Notes: ORMÔ01 is not used, and OMLÔ21 bears the usage. ORRÔ02 is not used either, and ORLÔ22
bears the usage.
1630
7.5.1 Laboratory Order Message (OMLÔ21, ORLÔ22)

The following message is used for analytical messages where it is required that the
Specimen/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

Refer to the HL7 standard for the OML message of HL7 2.5 Chapter 4 and the general
1640 message semantics.
In addition, when the Order Filler sends a new work order to the Automation Manager, ORC-
1“ Or de rCont r
olCode ”isva lue dwi th“ NW” .Whe nt hewor korder is canceled, ORC-1 is
valuedwi th“ CA” .Thec orrectionoft hewor korderus esva lue“ RP” .
TheOBX s egme ntsa reus edtoc onveyt hepa ti
ent’spre vi
ousr esult
s,a swe llass ome
observation provided by the Order Placer or by the Order Filler, such as: blood pressure,
pati
ent’st emperature,specimenc ol
le c
tionvol ume …
Table 7.5-1: OML^021 Message

] --- PATIENT end
[ --- OBSERVATION REQUEST begin O [0..1]
[TCD] Test Code Details O [0..1] 13
[{ --- SPECIMEN begin C [0..*]
[{ --- CONTAINER begin C [0..*]
SAC Specimen Container R [1..1] 13
[{OBX}] Additional specimen characteristics O [0..*] 7
}] --- CONTAINER end
}] --- SPECIMEN end
} --- ORDER end
1650 OMLÔ21ÔML_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 and
prepared, 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 the
previous result, ORC, OBR, and OBX for the previous result are not necessary.
The OBX segment in the OBSERVATION group is used for the vital signs if it is necessary
1660 for technical validation.
The OBX segment in the CONTAINER group is used when a rerun is ordered.
Table 7.5-2 : ORLÔ22 Message


[{ERR}] Error O [0..*] 2
[ --- PATIENT begin O [0..*]
] --- PATIENT end
[{ --- SPECIMEN begin C [0..*]
[{SAC}] Specimen Container Details C [0..*] 7
}] --- SPECIMEN end
] --- OBSERVATION end
}] --- OBSERVATION REQUEST end
] --- ORDER end
ORLÔ22ÔRL_O22
The PID, ORC and OBR segments are required in this message, to give back the filler order
number (ORC-3 or OBR-3).
The use conditions of SPM/SAC are the same as that of OMLÔ21.
1670 7.5.2 Laboratory Order for Multiple Orders Related to a Single Specimen
(OMLÔ33, ORLÔ34)
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“ anys ta
tusc hangeofawor kor der”.Suc
hcha
nges
include submission of new orders, cancellations, updates, etc where multiple orders are
associated with a single specimen, which may be carried in multiple containers.
7.5.2.2 Message semantics

1680 message semantics.
1“ Or de rCont r
olCode ”isva lue dwi th“ NW” .Whe nt hewor korde ri
sc ancel
ed,ORC-1 is
ent’spre vi
ousr esult
s,a swe llass ome
observation provided by the Order Placer or by the Order Filler, such as: blood pressure,
pati
le c
tionvol ume …
Table 7.5-3: OMLÔ33

] --- PATIENT end
[{SAC}] Specimen Container O [0..*]
[ --- OBSERVATION REQUEST begin O [O..1]
[TCD] Test Code Details O [0..1] 13
[{OBX}] Observation Result C [0..*] 7
{ --- PRIOR RESULT start O [0..*]
[ORC] Common order –prior result O [0..1] 4
OBR Order detail –prior result R [1..1] 4
{OBX} Observation/Result –prior result R [1..*]
} --- ORDER end
} --- SPECIMEN end
1690 Field MSH-9 – Message Type shall have its three components valued as follows:
OMLÔ33ÔML_O33
Table 7.5-4: ORLÔ34

[{ERR}] Error O [0..*] 2
[{SAC}] Specimen Container O [0..*] 13
}] --- ORDER end
} --- SPECIMEN end
Notes HL7 V2.5 Chapter 4 describe SPM and SAC under OBR segment. But, we cannot find out the necessity
of them.
ORLÔ34ÔRL_O34
Please refer to the section 7.5.1 (OMLÔ21) and ORLÔ22), for a detailed description of the
1700 segments composing the above messages.
7.5.3 Laboratory Order for Multiple Orders related to a Single Container of a

Specimen (OMLÔ35, ORLÔ36)
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 associated
with a single container of a specimen.
Not
esHL7V2.5Chapt er4des cri
bes“Thet rigger event for this message is any change to a laboratory order.
1710 Such changes include submission of new orders, cancellations, updates, etc where multiple orders
ar
eassoci at
edwi thasi ngl
es ampl ewhi chmaybecar ri
edinamul t
ipl
econt ainer
”.Thi si ss ameas
OMLÔ33, and it seems a miss of typing.
7.5.3.2 Message Semantics

message semantics.
1“ Or de rCont r
olCode ”isva lue dwi th“ NW” .Whe nt hewor korde ri
sc ancel
ed,ORC-1 is
ent’spre vi
ousr esult
s,a swe llass ome
1720 observation provided by the Order Placer or by the Order Filler, such as: blood pressure,
pati
le c
tionvol ume …
Table 7.5-5 : OMLÔ35

PID Patient identification R [1..1] 3
[PV1] Patient visit RE [0..1] 3
] --- PATIENT end
ORC Common order R [1..1] 4

[{TQ1}] Timing/Quantity Order Sequence RE [0..1] 4
[ TCD ] Test Code Details O [0..1] 13
[{OBX}] Additional specimen characteristics O [0..*] 7
{ --- PRIOR RESULT start O [0..*]
[ORC] Common order –prrior result O [0..1] 4
OBR Order detail –prior result R [1..1] 4
{OBX} Observation/Result - prior result R [1..*] 7
} --- ORDER end
} --- CONTAINER end
} --- SPECIMEN end
OMLÔ35ÔML_O35
Table 7.5-6 : ORLÔ36

MSH Message header R 2
MSA Message Acknowledgement R 2
[{ERR}] Error O 2
[OBR] Observation Request R 4
}] --- ORDER end
} --- CONTAINER end
] --- SPECIMEN END
1730 Field MSH-9 – Message Type shall have its three components valued as follows:
ORLÔ36ÔRL_O36
7.5.3.2.1 OBR segment

All fields are optional except those listed in table below.
Table 7.5-7 : OBR Segment

1 4 SI O [0..1] 00237 Set ID –OBR
10 250 XCN O [0..*] 00244 Collector Identifier *
12 250 CE X [0..0] 00246 Danger Code
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 +
25 1 ID X [0..0] 0123 00258 Result Status +
28 250 XCN O [0..*] 00260 Result Copies To
29 200 EIP X [0..0] 00261 Parent
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 *

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 Service
Information
47 250 CE O [0..1] 0411 01475 Filler Supplemental Service Information
Procedure Reason.
49 2 IS O [0..1] 0507 01647 Result Handling
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.
7.5.3.2.2 TCD segment

Table 7.5-8 : TCD Segment
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 Content of Pre-Dilution
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
7.5.3.3 Expected Action

If the OML message of the Order Control Code NW is received from Order Filler, the
Automation Manager will receive and register the order information, then it will transmit the
resulteit
her“
Accept”or“ Re ject”toOr de rFi l
le rbyt heORL message.
If the OML message of the Order Control Code CA is received from Order Filler,
1750 Automation Manager will cancel the existing previous order information, and will not try to
schedule 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 to
Order Filler by the ORL message.
Automation Manager will change and register record of the command, if the OML message
of 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 is
transmitted to Order Filler by the ORL message.
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 Scope
This transaction is used when Automation Manager transmits test results to Order Filler.
8.2 Use case roles

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.

HL7 Version 2.5--mainly referred to in Chapter 7.

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
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 general
message semantics.
Table 8.5-1 OUL^R22
chapter
[PID] Patient Identification RE [0..1] 3
[PV1] Patient Visit O [0..1] 3
SPM Specimen information R [1..1] 7
[{ OBX }] Observation Result (for Specimen) O [0..*] 7
[{ --- CONTAINER begin 0 [0..*]
SAC Container information R [1..1] 13
[INV] Detailed Substance information (e.g., id, lot, O [0..1] 13
manuf act
ure
r,… ofQCs peci
me n)
OBR Observation Order R [1..1] 7
[ORC] Common Order O [0..1] 4
[TCD] Test Code Detail O [0..1] 13
[{SID}] Substance Identifier (e.g., reagents used for testing) O [0..*] 13
[{NTE}] Notes and comments O [0..*]
}] --- RESULT end
} --- ORDER end
} --- SPECIMEN end
The carrier information in the case of notifying the test results of a patient's sample uses SAC.
Table 8.5-2 ACK^R22
[ERR] Error O [0..1] 2
1800
OUL^R22ÔUL_R22

Refer to the HL7 standard for the OUL message of HL7 2.4 or 2.5 Chapter 7 and the general
message semantics.
Table 8.5-3: OUL^R23

chapter
[{ OBX }] Observation Result (for Specimen) O [0..*] 7
[INV] Detailed Substance information (e.g., id, lot, O [0..1] 13
manuf act
urer
,… ofQCs pecime n)
[{SID}] Substance Identifier (e.g., reagents used for O [0..*] 13
testing)
}] --- RESULT end
} --- ORDER end
} --- CONTAINER end
} --- SPECIMEN end
1810 OUL^R23ÔUL_R23
Refer to HL7 Chapter 13 for INV, SID segments and refer to HL7 Chapter 7 for CTI segment.
Table 8.5-4 ACK^R23
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.

1820 Refer to the HL7 standard for the OUL message of HL7 2.5 Chapter 7 and the general
message semantics.
Table 8.5-5: OUL^R24

chapter
[ { --- SPECIMEN begin O [0..*]
Observation Result (for Specimen) O [0..*] 7
[{ OBX }]
[{ --- CONTAINER begin O [0..*]
Detailed Substance information (e.g., id, lot, O [0..1] 13
[INV] manuf act
ure
r,… ofQCs pecimen)
} ] --- SPECIMEN end
[{SID}] Substance Identifier (e.g., reagents used for testing) O [0..*] 13
}] --- RESULT end
} --- ORDER end
OUL^R24ÔUL_R24
Table 8.5-6: ACK^R24
1830 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
1 4 SI O [0..1] 00237 Set ID –OBR
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 *
12 250 CE X [0..0] 00246 Danger Code
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 C [0..1] 00255 Results Rpt/Status Chng - Date/Time +
25 1 ID R [1..1] 0123 00258 Result Status +
26 400 PRL O [0..1] 00259 Parent Result +
28 250 XCN O [0..*] 00260 Result Copies To
29 200 EIP O [0..1] 00261 Parent
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 *
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 Service
Information
47 250 CE O [0..1] 0411 01475 Filler Supplemental Service Information
Procedure Reason.
49 2 IS O [0..1] 0507 01647 Result Handling
All field data should reflect LAB-4t

rans
act
ion’
sOBR.
8.5.1.6 TCD segment

Table 8.5-8 : TCD segment
9 Real world use cases
9.1 Guidelines
Each of the real world use cases in this section are to be considered as a template for handling
1850 a 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 in
chronological order, completed by an interaction diagram, and illustrated by the most
significant 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 ctors’na me sa
rea bbreviated wi
tht hei
ri ni
ti
als( 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.
9.2 Two Hematology batteries on a blood specimen
9.2.1 Storyboard
This example corresponds to the us ec
asedescr
ibe
dinVol
ume1a s“Externally placed order
wi t
hs p eci
me nsuni de nt
ifiedort obec ol
lec
tedbythel
abor
ator
y”.Thes pe cime 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:
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.
1880 Technician: Marc Techos.
Clinical expert: Jane Cyto.
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 555 Urology department (OP)
Care unit order (1st battery) 9876543 Urology department (OP)
Care unit order (2nd battery) 9876544 Urology department (OP)
Laboratory order (1st battery) 456 Cytology laboratory (OF)
idem for work order
Laboratory order (2nd battery) 457 Cytology laboratory (OF)
idem for work order
Specimen 456_1 Cytology laboratory (OF)
LAB-1 interaction: The Care Unit collects a specimen related to an order for a blood count
and a differential count, and sends the specimen to the chemistry laboratory. The Order
Pla ce rsendsame ssage“ newor der”( NW)a ccompa ny i
ngthes pe cime n,tol et the laboratory
start the testing.
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
1890 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 Tracker
of the scheduled work.
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 the
Order 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 Order R esult

Manager Tracker
Order entered
specim en
sent to OMLÔ33 (NW)
laboratory 9.2.3.1
ORLÔ34 Specimens checked.
9.2.3.1
Order started
OMLÔ21 (NW)
9.2.3.2
OMLÔ33 (SC)
9.2.3.3 OUL^R22 (SC)
ACK^R22 9.2.3.4
9.2.3.4
technical
OUL^R22 (SC) validation
9.2.3.5
Clinical validation
OMLÔ33 (SC) OUL^R22 (SC)
9.2.3.6 9.2.3.7
1900 9.2.3 Messages
9.2.3.1 LAB-1 (OP  OF)

:Message“New or
der
”wi
thonespeci
men
A new placer order sent to the Order Filler:
MSH|^~\&|OP|Urology|OF|Cytology|200310060820||OMLÔ33ÔML_O33|001|T|2.5|||||USA||EN
PID|1||6543210^^Âbbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
PV1|1|I||||||||||||||||9998888
SPM|1|||BLD|||||||P||||||200310060735|||||||||1
ORC|NW|9876543Ûrology||555Ûrology
|||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^ÛR01
TQ1|1||||||||R
1910 OBR|1|9876543Ûrology||85027^Hemogram and platelet count, automated^CPT4|
|||||^COLLECT^JOHN||||||ÛRO^^^^DR
ORC|NW|9876544Ûrology||555Ûrology
|||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^ÛR01
TQ1|1||||||||R
OBR|1|9876544Ûrology||85009^Differential WBC Count, buffy coat^CPT4|
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.2.3.2 LAB-4 (OF  AM)

:Message“New or
der
”
A new work order is sent to the Automation Manager:
1920 MSH|^~\&|OF|Cytology|AM|Automation|200310060825||OMLÔ33ÔML_O33|101|T|2.5|||||USA|
|EN
PV1|1|I||||||||||||||||9998888
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||||||||1
ORC|NW|||555Ûrology|||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^ÛR01
TQ1|1||||||||R
OBR|1|456^Cytology||85027^Hemogram and platelet count, automated^CPT4|
ORC|NW|||555Ûrology|||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^ÛR01
1930 TQ1|1||||||||R
OBR|1|457^Cytology||85009^Differential WBC Count, buffy coat^CPT4|
Acknowledgement sent by the Automation Manager:

MSH|^~\&|AM|Automation|OF|Cytology|200310060826||ORLÔ34ÔRL_O34|301|T|2.5|||||USA|
EN
MSA|AA|101
1940 PID|1||6543210^^Âbbeville Hospital^PI||ILL^JOHN^^^^^L||19810101|M
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||||||||1
ORC|OK|||555Ûrology|SC||||200310060710|^NURSE^JANET|||||||||||
Urology^^^^^^FI^^ÛR01
TQ1|1||||||||R
|||||^COLLECT^JOHN|S|||||ÛRO^^^^DR
ORC|OK|||555Ûrology|SC||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
1950 OBR|1|457^Cytology||85009^Differential WBC Count, buffy coat^CPT4|
|||||^COLLECT^JOHN|S|||||ÛRO^^^^DR
9.2.3.3 LAB-1 (OF  OP)

:Message“St
atuschanged”
The placer order has been assigned a filler order number, the specimen is available and
identified by the laboratory:
MSH|^~\&|OF|Cytology|OP|Urology|200310060825||OMLÔ33ÔML_O33|108|T|2.5|||||USA||EN
PV1|1|I||||||||||||||||9998888
SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||Y||||||1
1960 ORC|SC|9876543Ûrology||555Ûrology|IP||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
OBR|1|9876543Ûrology|456^Cytology|85027^Hemogram and platelet count,
automated^CPT4|
|||||^COLLECT^JOHN|P|||||ÛRO^^^^DR|||||||||I
ORC|SC|9876544Ûrology||555Ûrology|IP||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
OBR|1|9876544Ûrology|457^Cytology|85009^Differential WBC Count, buffy coat^CPT4|
1970 |||||^COLLECT^JOHN|P|||||ÛRO^^^^DR|||||||||I
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.2.3.4 LAB-3 (OF->ORT)

:Message“New Or
der
”
The Order Result Tracker is notified of the creation of the filler order by means of a
result message:
MSH|^~\&|OF|Cytology|ORT||200310060825||OUL^R22ÔUL_R22|122|T|2.5|||||USA||EN
PV1|1|I||||||||||||||||9998888
1980 SPM|1|456_1^Cytology||BLD|||||||P||||||200310060735|200310060821||Y||||||1
automated^CPT4|
TQ1|1||||||||R
1990 Urology^^^^^^FI^^ÛR01
TQ1|1||||||||R
Acknowledgement sent by the Order Results Tracker:

MSH|^~\&|ORT||OF|Cytology|200310060826||ACK^R22ÂCK_R22|401|T|2.5|||||USA|EN
MSA|AA|122
9.2.3.5 LAB-5 (AM->OF): Message“New Resul

ts”
The Automation Manager sends the final results for the work order:
MSH|^~\&|AM|Automation|OF|Urology|200310060900||OUL^R22ÔUL_R22|308|T|2.5|||||USA||
2000 EN
PV1|1|I||||||||||||||||9998888
|||||^COLLECT^JOHN|P|||||ÛRO^^^^DR|
||||||200310060832|||F|||||||&TECHOS&MARC^200310060833
ORC|SC||||CM||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^ÛR01
OBX|1|NM|11156-7^LEUKOCYTES^LN||8.2|10*3/mm3|4-10|N|||F|||200310060830
OBX|2|NM|11273-0ÊRYTHROCYTES^LN||4.08|10*6/mm3|10-12|N|||F|||200310060830
2010 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|||||ÛRO^^^^DR
||||||200310060832|||F|||||||&TECHOS&MARC^200310060833
ORC|SC||||CM||||200310060710|^NURSE^JANET|||||||||||Urology^^^^^^FI^^ÛR01
2020 OBX|1|NM|23761-0^NEUTROPHILS/100 LEUKOCYTES^LN||72|%||N|||F|||200310060830
OBX|2|NM|26450-7ÊOSINOPHILS/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
ts
The related acknowledgement message isn’ hown.
9.2.3.6 LAB-1 (OF->OP)

:Message“
Stat
usChanged”
The clinical expert has performed the clinical validation at 09h29. The order is
2030 completed:
MSH|^~\&|OF|Urology| OP|Urology|200310060930||OMLÔ33ÔML_O33|181|T|2.5|||||USA||EN
PV1|1|I||||||||||||||||9998888
ORC|SC|9876543Ûrology||555Ûrology|CM||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
automated^CPT4|
2040 |||||^COLLECT^JOHN|P|||||ÛRO^^^^DR|||||||||F|||||||&CYTO&JANE^200310060929
TQ1|1||||||||R
|||||^COLLECT^JOHN|P|||||ÛRO^^^^DR|||||||||F|||||||&CYTO&JANE^200310060929
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.2.3.7 LAB-3 (OF->ORT)

:Message“St
atusChanged”
2050 The clinical expert has performed the clinical validation at 09h29. The order is
completed. The results are final:
MSH|^~\&|OF|Cytology|ORT||200310060931||OUL^R22ÔUL_R22|182|T|2.5|||||USA||EN
PV1|1|I||||||||||||||||9998888
automated^CPT4|
||||||200310060929|||F|||||||&CYTO&JANE^200310060929
2060 ORC|SC|9876543Ûrology||555Ûrology|CM||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
OBX|1|NM|11156-7^LEUKOCYTES^LN||8.2|10*3/mm3|4-10|N|||F|||200310060830
OBX|2|NM|11273-0ÊRYTHROCYTES^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
2070 OBX|8|NM|11125-2^PLATELETS^LN||220|10*9/L|150-400|N|||F|||200310060830
||||||200310060929|||F|||||||&CYTO&JANE^200310060929
TQ1|1||||||||R
OBX|1|NM|23761-0^NEUTROPHILS/100 LEUKOCYTES^LN||72|%||N|||F|||200310060830
OBX|2|NM|26450-7ÊOSINOPHILS/100 LEUKOCYTES^LN||2|%||N|||F|||200310060830
OBX|3|NM|26478-8^LYMPHOCYTES/100 LEUKOCYTES^LN||20|%||N|||F|||200310060830
2080 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
s
The related acknowledgement mesa
gei
sn’
tshown.
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 erna l
lypl acedor derwi thide ntif
ie ds pe ci
me ns ”.Theor deringc areunit 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 a
number of specimens, to be performed by the chemistry laboratory. The order is assumed to
bepa r
tofag roupofpl ace
ror dersi dent i
fiedbyt hepl acerg roupnumbe r‘666’.
Glucose tolerance is ordered as a single battery requesting for glucose test on an unspecified
number of blood serum dr a wna tdi ff
erentinterva l
s,afterinitialg l
ucos ei nge st
ion”.TheSPM
segments 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 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.
2110 Clinical expert: Jane Chemistry-Expert, ID number 444444.
Patient ID 12345 Admission office (ADT)
Care unit order 12345678 Entero-gastric department (OP)
Care unit order group 666 Entero-gastric department (OP)
1st specimen 123456781 Entero-gastric department (OP)
2nd specimen 123456782 Entero-gastric department (OP)
3rd specimen 123456783 Entero-gastric department (OP)
4th specimen 123456784 Entero-gastric department (OP)
5th specimen 123456785 Entero-gastric department (OP)
Laboratory order 555 Chemistry laboratory (OF)
1st work order 555_1 Chemistry laboratory (OF)
2nd work order 555_2 Chemistry laboratory (OF)
3rd work order 555_3 Chemistry laboratory (OF)
4th work order 555_4 Chemistry laboratory (OF)
LAB-1 interaction: The Care Unit collects the first three specimens related to an order for
glucos etole r
a nce,wi t
ht hehi ghpr iorit
y‘ ASAP’ ,a nds e
nds these specimens to the chemistry
labora t
ory.TheOr de rPl ace rsendsame ss age“ newor der
”( NW)a ccompany ingt hef i
rs t
three specimens, to let the laboratory start the testing. OBR-11“ Spe cimenac ti
onc ode”i s
value dto“ P”( pendi ngs pec ime n)indicatingthat some specimens for this order are still
pending (i.e. not yet collected). The order placer provides an observation reporting the initial
quantity of sugar absorbed by the patient.
LAB-4, LAB-1 and LAB-3 interactions: The laboratory checks the specimens and
2120 schedules 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,
notify i
ngtha tthethir ds pecime nb eingbr oken,won’ tproduc eanyobservation. SPM-20
(spec imena vailabi
lity )=‘ N’a ndSPM-21( specime nr ejectre as
on)=‘ RB’(broke n
cont ainer
).Sinc ethisi sat imings er
ie s,theOr de rPl a
c erwon’ tr
eplacet hi
sspe ci
me n.There
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
pri
or i
tyi s“ ASAP” ,theOr derFi ll
ernot i
fiesthes epa rti
alresultt otheOr 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, wit
htheor derc ont rol“ c
ha ngeor der
request”( XO) .Thi sme ssagecontainst hec ompl eteli
stofspe ci
me ns .OBR-11“ Spe cimen
acti
onc ode ”isva l
ue dto“ S”,indi
ca t
ingt ha tthes pe
cimenc oll
ec tioni sc ompl ete,a ndthatthe
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.
Order Placer Order Filler Automation Order Result

Manager Tracker
Order entered
First 3
specimens
OMLÔ21 (NW)
sent to
9.3.3.1 Specimens checked.
laboratory
Order started
OMLÔ21 (NW)
OMLÔ21 (SC)
9.3.3.2
9.3.3.3
OUL^R24 (NW)
9.3.3.4
first technical
OMLÔ21 (SC)
9.3.3.5 OUL^R24 (SC)
9.3.3.6
9.3.3.7
Last 2
specimens OMLÔ21 (XO)
sent to 9.3.3.8 Last specimens checked.
laboratory
OMLÔ21 (NW)
OMLÔ21 (SC) 9.3.3.9 OUL^R24 (SC)
9.3.3.10
9.3.3.11
OUL^R21 (SC) last technical validation

9.3.3.12
Clinical validation
OMLÔ21 (SC) OUL^R24 (SC)
9.3.3.13 9.3.3.14
9.3.3 Messages
9.3.3.1 LAB-1 (OP  OF)

:Message“New or
der
”wi
tht
hef
ir
st3speci
mens
A ne w pl aceror ders e
ntt ot heOr derFi ller:Pr i
orit
y“ ASAP”f ort hi
spl ac eror de
r.One
observation provided by the placer. Three first specimens collected. The other specimens are
2150 pending.
MSH|^~\&|OP|Entero-gastric|OF|Chemistry|200309060820||OMLÔ21ÔML_O21|
msgOP123|T|2.5|123| |||USA||EN
PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMANÂDAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
ORC|NW|12345678^gastric||666^gastric|||||200309060710|222221^NURSE^NANCY|||||||||||
Entero-gastric^^^^^^FI^^ÊG02
TQ1|||||||||A
OBR||12345678^gastric||82951^Glucose Tolerance Test^CPT4||||||1234^BLEEDER|
2160 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
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.2 LAB-4 (OF  AM)

:Message“New or
der
”wi
tht
hef
ir
st2speci
mens
Two new work orders sent to the Automation Manager: Priority ASAP. One observation
2170 provided.
MSH|^~\&|OF|Chemistry|AM|Automation|200309060825||OMLÔ21ÔML_O21|msgOF101|T|2.5|12
3||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
ORC|NW|||666^gastric|||||200309060824|222221^NURSE^NANCY|||||||||||
TQ1|||||||||A
OBR||555_1^chemistry||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||222222^PHYSICIAN^^^^DR
|821
2180 SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||||||||1
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
ssa
gei
sn’
tshown.
2190 9.3.3.3 LAB-1 (OF  OP)

:Message“St
atuschanged”wi
tht
hef
irst3
specimens
The placer order has been assigned a filler order number. One specimen is rejected:
MSH|^~\&|OF|Chemistry|OP|Entero-gastric|200309060825||OMLÔ21ÔML_O21|msgOF102|
T|2.5|123| |||USA||EN
PV1|1|O|Ward|||||||||||||||12345
ORC|SC|12345678^gastric||666^gastric |IP||||200309060824|222221^NURSE^NANCY
||||||||||| Entero-gastric^^^^^^FI^^ÊG02
TQ1|||||||||A
2200 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|3|123456783^gastric ||SER|||||||P||||||200309060815|200309060821||N|RB|||||1
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.4 LAB-3 (OF  ORT)

:Message“New or
der
”wi
tht
hef
irst3speci
mens
The Order Result Tracker is notified with the creation of the filler order: One
2210 observation is canceled.
MSH|^~\&|OF|Chemistry|ORT||200309060825||OUL^R24ÔUL_R24|msgOF103|T|2.5|123||||USA|
|EN
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^^ÊG02
TQ1|||||||||A
2220 SPM|1|123456781^gastric ||SER|||||||P||||||200309060735|200309060821||Y||||||1
OBX|1|NM|30264-6^GLUCOSE 40M POST DOSE GLUCOSE^LN||||||||X
OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.5 LAB-5 (AM OF)

:Message“New r
esul
ts”f
ort
hef
irst2wor
kor
der
s
The Automation Manager sends the two final results for the 2 work orders, technically
validated by Suzy TECHNICIAN at 8h33:
2230 MSH|^~\&|AM|Automation|OF|Chemistry|200309060833||OUL^R24ÔUL_R24|msgAM1|T|2.5|123|
|||USA||EN
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
2240 OBX|1|NM|14749-6^GLUCOSE^LN||6000|umol/l||N|||F|||200309060832
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.6 LAB-1 (OF  OP)

:Message“St
atuschanged”
Some results are available, not clinically validated (i.e. not verified)
T|2.5|123| |||USA||EN
PV1|1|O|Ward|||||||||||||||12345
2250 ORC|SC|12345678^gastric||666^gastric|A||||200309060834|222221^NURSE^NANCY|
||||||||||Entero-gastric^^^^^^FI^^ÊG02
TQ1|||||||||A
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance
Test^CPT4||||||1234^BLEEDER|P|||||222222^PHYSICIAN^^^^DR|821||||||||R
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
2260
9.3.3.7 LAB-3 (OF  ORT)

:Message“St
atuschanged”
The two first results are sent, not clinically validated (i.e. not verified):
|EN
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|
2270 ||||||||||Entero-gastric^^^^^^FI^^ÊG02
TQ1|||||||||A
OBX|1|NM|14996-3^GLUCOSE PRE 75 G GLUCOSE PO^LN||4200|umol/l|4000-6100|N|||
R|||200309060830
OBX|1|NM|30263-8^GLUCOSE 20M POST DOSE GLUCOSE^LN||6000|umol/l|<7800|N|||
R|||200309060832
OBX|1|NM|30264-6^GLUCOSE 40M POST DOSE GLUCOSE^LN|| | |||||X
2280 OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.8 LAB-1(OP  OF): Message “Changeor

der
/ser
vicer
equest
”
The last 2 specimens have been collected and are sent to the laboratory:
MSH|^~\&|OP|Entero-gastric|OF|Chemistry|200309060900||OMLÔ21ÔML_O21|msgOP124|
T|2.5|123| |||USA||EN
PV1|1|O|Ward|||||||||||||||12345
2290 ORC|XO|12345678^gastric||666^gastric|||||200309060855|222221^NURSE^NANCY|
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
2300 SPM|5|123456785^gastric ||SER|||||||P||||||200309060855|||||||||1
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.9 LAB-4 (OF  AM)

:Message“New or
der
”wi
tht
he last 2 specimens
Two new work orders sent to the Automation Manager:
MSH|^~\&|OF|Chemistry|AM|Automation|200309060905||OMLÔ21ÔML_O21|msgOF106|T|2.5|12
3| |||USA||EN
PV1|1|O|Ward|||||||||||||||12345
2310 ORC|NW|||666^gastric|||||200309060904|222221^NURSE^NANCY|||||||||||
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
TQ1|||||||||A
OBR||555_5^chemistry ||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||
2320 222222^PHYSICIAN^^^^DR|821
SPM|1|123456785^gastric ||SER|||||||P||||||200309060855|200309060902||||||||1
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.10 LAB-1 (OF  OP)

:Message“St
atuschanged”wi
thal
lspeci
mens
All the specimens have been checked by the laboratory staff.
T|2.5|123| |||USA||EN
2330 PV1|1|O|Ward|||||||||||||||12345
ORC|SC|12345678^gastric||666^gastric|A||||200309060904|222221^NURSE^NANCY|
TQ1|||||||||A
OBR||12345678^gastric|555^chemistry|82951^Glucose Tolerance test^CPT4||||||
1234^BLEEDER|P|||||222222^PHYSICIAN^^^^DR|821||||||||R
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.11 LAB-3 (OF  ORT)

:Message“St
atuschanged”
The last two specimens have been received. All the work is scheduled:
|EN
PV1|1|O|Ward|||||||||||||||12345
2350 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^^ÊG02
TQ1|||||||||A
R|||200309060830
2360 R|||200309060832
OBX|1|NM|30264-6^GLUCOSE 40M POST DOSE GLUCOSE^LN|| | |||||X
OBX|1|NM|GLUCOSE||75|g|||||F|||200309060735
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.12 LAB-5 (AM OF)

:Message“New r
esul
ts”f
ort
hel
ast2wor
kor
der
s
2370 The Automation Manager sends the two final results for the 2 work orders, technically
validated by Suzy TECHNICIAN at 9h12.
MSH|^~\&|AM|Automation|OF|Chemistry |200309060912||OUL^R24ÔUL_R24|msgAM2|
T|2.5|123||||USA ||EN
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
OBR||555_5^chemistry ||GLUC^GLUCOSE^L||||||1234^BLEEDER|S|||||
2380 222222^PHYSICIAN^^^^DR|821||||||200309060911|||F|||||||333333&TECHNICIAN&Suzy^20030
9060912
The related acknowl

edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.13 LAB-1 (OF  OP)

:Message“St
atuschanged”
Jane CHEMISTRY-EXPERT has performed the clinical validation at 9h29. The order
2390 is completed.
T|2.5|123||| |USA||EN
PV1|1|O|Ward|||||||||||||||12345
ORC|SC|12345678^gastric||666^gastric|CM||||200309060929|222221^NURSE^NANCY|||||||||
||Entero-gastric^^^^^^FI^^ÊG02
TQ1|||||||||A
1234^BLEEDER|S|||||222222^PHYSICIAN^^^^DR|821||||||200309060929|||F|||||||
2400 444444&CHEMISTRY-EXPERT&Jane^200309060929
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.3.3.14 LAB-3 (OF  ORT)

:Message“St
atuschanged”
2410 Jane CHEMISTRY-EXPERT has performed the clinical validation at 9h29. The order
is completed. The results are final.
|EN
PV1|1|O|Ward|||||||||||||||12345
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|||||||||
2420 ||Entero-gastric^^^^^^FI^^ÊG02
TQ1|||||||||A
F|||200309060830
F|||200309060832
OBX|1|NM|30264-6^GLUCOSE 40M POST DOSE GLUCOSE^LN||||||||X
OBX|1|NM|14756-1^GLUCOSE 1H POST DOSE GLUCOSE^LN||7200|umol/l|<7800|N|||
F|||200309060910
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
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
2440
9.4 Battery with 2 specimens: Creatinine clearance
9.4.1 Storyboard
Thise xampl ec orrespondst otheus ec
asedescr
ibe
dinVol
ume1a s“Externally placed order
wi t
hs pec i
me nsuni dentifiedort obec ol
lec
tedbythel
abor
ator
y”.Thes pe cime nsa renot
identified by the ordering care unit.
Dr Nephro orders one battery of one test: a creatinine clearance.
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 the
collected urine volume, records the duration of collection, takes a urine sample from the 24
2450 hours 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’ .

Assigning authority: Abbeville Hospital
Placer: Nephrology department.
Filler: Chemistry laboratory.
Ordering facility: Nephrology.
Patient: John Ill, Patient hospital identifier: 6543210, Patient visit number:
2460 999888, class = inpatient
Orderer: Dr Nephro.
Placer order enterer: Janet Nurse.
Specimen collector: John Collect.
Technician: Marc Techos.
Clinical expert: Jane Chemistry.

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) 654 Chemistry laboratory (OF)
idem for work order
Specimen Serum 654_1 Chemistry laboratory (OF)
Specimen Urine 654_2 Chemistry laboratory (OF)
LAB-1 interaction: The Care Unit processes the specimen collection related to an order for a
2470 creatinine clearance, and sends the notified or measured values and the specimens to the
che mistryl aboratory .TheOr de rPla cers endsame s
sag
e“newor der”( NW)a ccompa nyi ng
the specimen, to let the laboratory start the testing.
LAB-4, LAB-1 and LAB-3 interactions: The laboratory checks the specimens and
schedules the work. An identifier is assigned to the specimens by the Order Filler and the
corresponding identification labels are printed out. The Order Filler sends a unique work
order to the Automation Manager. The Order Filler notifies both Order Placer and Order
Result Tracker of the scheduled work.
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 the
2480 Order 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 last
interaction in transaction LAB-3 shows a a negative acknowledgement and a repetition of the
message followed by the final positive acknowledgement.
Order Placer Order Filler Automation Order Result

Manager Tracker
Order entered
specimen
sent to OMLÔ21 (NW)
laboratory 9.4.3.1
Specimens checked.
Order started
OMLÔ21 (NW)
9.4.3.2
OMLÔ21 (SC)
9.4.3.3 OUL^R24 (NW)
9.4.3.4
technical
9.4.3.5
Clinical validation
OMLÔ21 (SC)
OUL^R24 (SC) 9.4.3.7
9.4.3.6
ACK^R24 (ERR)
OUL^R24 (SC)
ACK^R24 (OK)
9.4.3 Messages
9.4.3.1 LAB-1 (OP  OF)

:Message“New or
der
”wi
thonespeci
men
2490 A new placer order sent to the Order Filler:
MSH|^~\&|OP|Nephrology|OF|Chemistry|200310060820||OMLÔ21ÔML_O21|001|T|2.5|||||USA
||EN
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
2500 OBX|1|NM|13362-9ÛRINE COLLECTION DURATION^LN||24|hr|||||F|||200309060735
OBX|2|NM|19153-6ÛRINE SPECIMEN VOLUME^LN||2500|ml|||||F|||200309060735
SPM|1|||SER|||||||P||||||200310060735|||||||||1
SPM|2|||UR|||||||P||||||200310060735|||||||||1
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.4.3.2 LAB-4 (OF  AM)

:Message“New or
der
”
A new work order is sent to the Automation Manager:
MSH|^~\&|OF|Chemistry|AM|Automation|200310060825||OMLÔ21ÔML_O21|011|T|2.5|||||USA
||EN
PV1|1|I||||||||||||||||9998888
ORC|NW|||777^Nephro |||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
OBR|1|654^chemistry||82575^Creatinine clearance^CPT4||||||^COLLECT^JOHN|S|||||
^NEPHRO^^^^DR
OBX|1|NM|13362-9ÛRINE COLLECTION DURATION^LN||24|hr|||||F|||200309060735
SPM|1|654_1^chemistry||SER|||||||P||||||200310060735|200310060821||||||||1
2520 SPM|2|654_2^chemistry||UR|||||||P||||||200310060735|200310060821||||||||1
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.4.3.3 LAB-1 (OF  OP)

:Message“St
atuschanged”
The placer order has been assigned a filler order number, the specimen is available and
identified by the laboratory:
MSH|^~\&|OF|Chemistry|OP|Nephrology|200310060825||OMLÔ21ÔML_O21|012|T|2.5|||||USA
||EN
2530 PV1|1|I||||||||||||||||9998888
ORC|SC|9876543^Nephro||777^Nephro|IP||||200310060710|^NURSE^JANET|||||||||||
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
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
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:
MSH|^~\&|OF|Chemistry|ORT||200310060825||OUL^R24ÔUL_R24|013|T|2.5|||||USA||EN
PV1|1|I||||||||||||||||9998888
|||||^COLLECT^JOHN|P|||||^NEPHRO^^^^DR|||||||||I
ORC|SC|9876543^Nephro||777^Nephro|IP||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
2550 OBX|1|NM|13362-9ÛRINE COLLECTION DURATION^LN||24|hr|||||F|||200309060735
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.4.3.5 LAB-5 (AM->OF)

:Message“New Resul
ts”
The Automation Manager sends the final results for the work order:
MSH|^~\&|AM|Automation|OF|Nephrology|200310060900||OUL^R24ÔUL_R24|3331|T|2.5|||||
2560 USA||EN
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
OBX|1|NM|15045-8^SERUM CREATININE^LN||93|umol/l|50-100|N|||F|||200310060830
OBX|1|NM|14684-5^24H URINE CREATININE ^LN||7.06|mmol|8-16 (/24hr)|L|||F|||
2570 200310060830
OBX|2|NM|2164-2^CREATININE CLEARANCE^LN||52.7|ml/min|88-174|L||S|F|||200310060830
The relateda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.4.3.6 LAB-1 (OF->OP)

:Message“
Stat
usChanged”
completed:
MSH|^~\&|OF|Nephrology|OP|Nephrology|200310060930||OMLÔ21ÔML_O21|014|T|2.5|||||
USA||EN
PV1|1|I||||||||||||||||9998888
ORC|SC|9876543^Nephro||777^Nephro|CM||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
|||||^COLLECT^JOHN|P|||||^NEPHRO^^^^DR|||||||||F|||||||&CYTO&JANE^200310060929
2590 Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.4.3.7 LAB-3 (OF->ORT)

:Message“St
atusChanged”
completed. The results are final:
PV1|1|I||||||||||||||||9998888
OBR|1|9876543^Nephro|654^chemistry |82575^Creatinine clearance^CPT4||||||
^COLLECT^JOHN |P|||||^NEPHRO^^^^DR|||||||200310060929|||F|||||||
2600 &CYTO&JANE^200310060929
ORC|SC|9876543^Nephro||777^Nephro|CM||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
OBX|3|NM|14684-5^24H URINE CREATININE^LN||7.06|mmol|8-16 (/24hr)|L|||F|||
2610 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 skst
hes e
nde rto
repeat its message later.
MSH|^~\&|ORT||OF|Cytology|200310060932||ACK^R24|401|T|2.5|||||USA|EN
MSA|AE|015
2620 ERR|||206Âpplication record locked|E
Repetition of the same result message by the Order Filler, one minute later
PV1|1|I||||||||||||||||9998888
OBR|1|9876543^Nephro|654^chemistry |82575^Creatinine clearance^CPT4||||||
^COLLECT^JOHN |P|||||^NEPHRO^^^^DR|||||||200310060929|||F|||||||
&CYTO&JANE^200310060929
2630 ORC|SC|9876543^Nephro||777^Nephro|CM||||200310060710|^NURSE^JANET|||||||||||
TQ1|1||||||||R
OBX|3|NM|14684-5^24H URINE CREATININE^LN||7.06|mmol|8-16 (/24hr)|L|||F|||
200310060830
2640 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
9.5 Microbiology with two specimens and three germs identified
2650 9.5.1 Storyboard

This storyboard illustrates the use of transaction LAB-2 to notify generated batteries at the
Order Filler level (i.e. antibiotic susceptibilities, within the same placer group number).
Dr Physician orders Microscopy and Culture for two different specimens collected from the
same patient. The first specimen is Mid Stream Urine and the second one is Pus taken from a
wound 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 OMLÔ33 message. Since both specimens are part of the same
prescription, 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 the
laboratory technician in the Order Filler system, there is then neither LAB-4, nor LAB-5
transaction in this story board. We also presume that results for observations related to the
urine specimen are transferred as soon they are available, whilst the Clinical Expert desires to
review results related to other specimen types before they are released.
Assigning authority: Memphis Hosp 1
Placer: Emergency Ward
Filler: Microbiology
Ordering facility: Emergency Ward
2670 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.
Patient ID 12345 Admission office (ADT)
Care unit order for Urine Spec. 12345679 Emergency Ward (OP)
Care unit order for Pus Spec. 12345670 Emergency Ward (OP)
Care unit order group 777 Emergency Ward (OP)
1st specimen 123456791 Emergency Ward (OP)
2nd specimen 123456701 Emergency Ward (OP)
Laboratory order for the Urine MSU0309922 Microbiology laboratory (OF)
Laboratory order for the PUS PUS0300666 Microbiology laboratory (OF)
Day 1 at 8:10 LAB-1 interaction: The two specimens are collected and transmitted to the
2680 Microbiology laboratory in Routine. The Orde
rPl
ace
rsendsame ssage“ newor de
r”( NW)t o
the order placer.
Day 1 at 8:20 LAB-1 and LAB-3 interactions: The laboratory checks the specimens and
schedules the work. The Order Filler notifies both Order Placer and Order Result Tracker of
the 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, and
notifies the status change to the Order Placer, without waiting for the clinical validation.
Day 2 at 09:40 LAB-2 and LAB-3 interactions: The following day, the Urine culture is
positive, the laboratory adds Organism identification and Antibiotic Susceptibility test for this
2690 specimen. 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 and
Culture is positive for the Pus specimen, the clinical expert has validated these preliminary
results and the laboratory adds Organism identification and Antibiotic Susceptibility test for
this 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
2700 LAB-3.
Day 3 at 11:32 LAB-1 and LAB-3 interactions: The next day, organism identification and
Antibiotic 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 status
change to the Order Placer.
2710
2710 9.5.3 Messages
9.5.3.1 LAB-1 (OP  OF)

:Message“New or
der
”wi
tht
wospeci
mens
Day 1 at 8:10 A new placer order sent to the Order Filler.
MSH|^~\&|OP|Emergency Ward|OF|Microbiology|200309060810||OMLÔ33ÔML_O33|msgOP123|
T|2.5|123 ||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791Êmergency||MSU^Mid Stream Urine^L|||||||P||||||
200309060800|||||||||1
ORC|NW|12345679Êmergency||777Êmergency|||||200309060800|222221^NURSE^NANCY|||||||
2720 ||||Emergency Ward^^^^^^FI^^ÊW00
TQ1|||||||||R
OBR|1|12345679Êmergency||87086Ûrine Microscopy and Culture^CPT4|||||||S|||||
222222^PHYSICIAN^^^^DR|
SPM|2|123456701Êmergency||PUS||||TOE|LEFT||P||||||200309060805|||||||||1
ORC|NW|12345670Êmergency||777Êmergency|||||200309060800|222221^NURSE^NANCY|||||||
||||Emergency Ward^^^^^^FI^^ÊW00
TQ1|||||||||R
OBR|1|12345670Êmergency||87040^Microscopy and Culture^CPT4||||||222221^NURSE^NANCY
|S|||||222222^PHYSICIAN^^^^DR|
2730
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.5.3.2 LAB-1 (OF  OP)

:Message“St
atuschanged”
Day 1 at 8:20 Specimens have been received by the laboratory. A filler order number
has been assigner to the order.
MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309060820||OMLÔ33ÔML_O33|msgOF11|
T|2.5|123 ||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791Êmergency||MSU^Mid Stream
2740 Urine^L|||||||P||||||200309060800|200309060818||Y|…
ORC|SC|12345679Êmergency||777Êmergency|IP||||200309060818||||||||||||
Emergency Ward^^^^^^FI^^ÊW00
OBR|1|12345679Êmergency|MSU0309922^Micro|87086Ûrine Microscopy and
Culture^CPT4|||||||S|||||222222^PHYSICIAN^^^^DR|
SPM|2|123456701Êmergency||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
OBR|1|12345670Êmergency|PUS0300666^Micro|87040^Microscopy and Culture^CPT4
||||||222221^NURSE^NANCY |S|||||222222^PHYSICIAN^^^^DR|
2750
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.5.3.3 LAB-3 (OF  ORT)

:Message“New or
der
”
Day 1 at 8:20 The Order Result Tracker is notified with the creation of the filler order:
MSH|^~\&|OF|Microbiology|ORT||200309060820||OUL^R22ÔUL_R22|msgOF12|T|2.5|123||||
USA||EN
PV1|1|O|Ward|||||||||||||||12345
2760 Urine^L|||||||P||||||200309060800|200309060818||Y|…
Culture^CPT4||||||| |||||222222^PHYSICIAN^^^^DR|
OBR|1|12345670Êmergency|PUS0300666^Micro|87040^Microscopy and
Culture^CPT4||||||222221^NURSE^NANCY ||||||222222^PHYSICIAN^^^^DR|
ORC|NW|12345670Êmergency||777Êmergency|IP||||200309060818||||||||||||
2770 Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.5.3.4 LAB-1 (OF  OP)

:Message“St
atuschanged”
Day 1 at 14:46 Urine Microscopy results are available, not clinically validated (i.e. not
verified)
T|2.5|123 ||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
2780 SPM|1|123456791Êmergency||MSU^Mid Stream Urine^L|||||||P||||||200309060800|
200309060818||Y|…
ORC|SC|12345679Êmergency||777Êmergency|A||||200309060818||||||||||||
OBR|1|12345679Êmergency|MSU0309922^Micro|87086Ûrine Microscopy and culture^CPT4|
||||||P|||| |222222^PHYSICIAN^^^^DR|
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.5.3.5 LAB-3 (OF  ORT)

:Message“St
atuschanged”
2790 Day 1 at 14:46 Urine Microscopy results are sent, not clinically validated (i.e. not
verified):
MSH|^~\&|OF|Microbiology|ORT||200309061446||OUL^R22ÔUL_R22|msgOF14|T|2.5|123||||US
A||EN
PV1|1|O|Ward|||||||||||||||12345
Urine^L|||||||P||||||200309060800|200309060818||Y|…
2800 Culture^CPT4||||||| |||||222222^PHYSICIAN^^^^DR||||||||MB|A
TQ1|||||||||R
OBX|1|CE|20453-7Êpithelial 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|32776-7Êrythrocytes^LN||value|/ml||N|||R|||200309061445|
|333231^BACK^TERRY
OBX|4|CE|24124-0^Casts^LN||value|||N|||R|||200309061445||333231^BACK^TERRY
2810 OBX|5|NM|699-9Ôrganism Count^LN||value|/ml||N|||R|||200309061445|
|333231^BACK^TERRY
OBX|6||20430-5^Culture^LN|||||N|||I|||200309070935||333231^BACK^TERRY
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
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:
2820 MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309070940||OMLÔ33ÔML_O33|msgOF15|

T|2.5|123 ||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
Urine^L|||||||P||||||200309060800|200309060818||Y|…
ORC|SN|||777Êmergency|||||200309070938|333231^BACK^TERRY|||||||||||
OBR|1||MSU0309922^Micro|87088Ôrganism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
2830 ORC|SN|||777Êmergency|||||200309070938|333231^BACK^TERRY|||||||||||Emergency
Ward^^^^^^FI^^ÊW00
OBR|2||MSU0309922^Micro|87186Ântibiotic Susceptibility^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
Acknowledgement sent by the Order Placer:

MSH|^~\&|OP|Emergency
Ward|OF|Microbiology|200309070940||ORLÔ34ÔRL_O34|msgOP123|T|2.5|123 ||||USA||EN
MSA|AA| msgOF15
2840 PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMANÂDAM^^JR^^^L|19800101|M
Urine^L|||||||P||||||200309060800|200309060818||Y|…
ORC|NA|12345681Êmergency||777Êmergency|||||200309070938|333231^BACK^TERRY||||||||
|||Emergency Ward^^^^^^FI^^ÊW00
OBR|1|12345681Êmergency|MSU0309922^Micro|87088Ôrganism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
OBR|2|12345682Êmergency|MSU0309922^Micro|87186Ântibiotic
2850 Susceptibility^CPT4||||||| G|||||222222^PHYSICIAN^^^^DR||||||||MB
9.5.3.7 LAB-3 (OF  ORT)

:Message“St
atusChanged”
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
MSH|^~\&|OF|Microbiology|ORT||200309070942||OUL^R22ÔUL_R22|msgOF16|T|2.5|123||||US
A||EN
2860 PID|1||12345^5^M10^Memphis_Hosp^PI||EVERYMANÂDAM^^JR^^^L|19800101|M
PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456791Êmergency||MSU^Mid Stream Urine^L|||||||P||||||200309060800|
200309060818||Y|…
Culture^CPT4||||||| |||||222222^PHYSICIAN^^^^DR||||||||MB|R
TQ1|||||||||R
OBX|1|CE|20453-7Êpithelial Cells^LN||value|||N|||R|||200309061445|
2870 |333231^BACK^TERRY
OBX|2|NM|20455-2^Leukocytes^LN||value|/ml||N|||R|||200309061445| |333231^BACK^TERRY
OBX|3|NM|32776-7Êrythrocytes^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|699-9Ôrganism 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
2880 G|||||222222^PHYSICIAN^^^^DR||||||||MB|S
ORC|SC|12345681Êmergency||777Êmergency|IP||||200309070938|333231^BACK^TERRY||||||
|||||Emergency Ward^^^^^^FI^^ÊW00
OBR|3|12345682Êmergency|MSU0309922^Micro|87186Ântibiotic
Susceptibility^CPT4||||||| G|||||222222^PHYSICIAN^^^^DR||||||||MB|S
The related acknowledgement message i

sn’
tshown.
2890 9.5.3.8 LAB-1 (OF  OP) :Message“St atuschanged”

Day 2 at 09:45 Microscopy and Culture results are available for the Pus specimen,
T|2.5| 123||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
2900 OBR|1|12345670Êmergency|PUS0300666^Micro|87040^Microscopy and Culture^CPT4|||||||
|||||222222^PHYSICIAN^^^^DR|
Ther
ela
teda
cknowl
edg
eme
ntme
ssa
gei
sn’
tshown.
9.5.3.9 LAB-2(OF  OP)

:Message“SendOr
derNumber
”
Day 2 at 9:45 Culture for Pus specimen is positive, Organism Identification and
Antibiotic Susceptibility tests are added:
MSH|^~\&|OF|Microbiology|OP|Emergency Ward|200309070945||OMLÔ33|msgOF18|T|2.5|123
2910 ||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
OBR|1||PUS0300666^Micro|87088Ôrganism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
Emergency Ward^^^^^^FI^^ÊW00 OBR|2||PUS0300666^Micro|87186Ântibiotic
2920 Susceptibility^CPT4||||||| G|||||222222^PHYSICIAN^^^^DR||||||||MB
Acknowledgement sent by the Order Placer:
MSH|^~\&|OP|Emergency
Ward|OF|Microbiology|200309070945||ORLÔ34ÔRL_O34|msgOP124|T|2.5| 123||||USA||EN
MSA|AA|msgOF18
2930 ORC|NA|12345685Êmergency||777Êmergency|||||200309070941|333231^BACK^TERRY||||||||
OBR|1|12345685Êmergency|PUS0300666^Micro|87088Ôrganism Identification^CPT4|||||||
G|||||222222^PHYSICIAN^^^^DR||||||||MB
OBR|2|12345686Êmergency|PUS0300666^Micro|87186Ântibiotic
Susceptibility^CPT4|||||||G|||||222222^PHYSICIAN^^^^DR||||||||MB
9.5.3.10 LAB-3 (OF  ORT)

:Message“St
atusChanged”
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.
MSH|^~\&|OF|Microbiology|ORT||200309070945||OUL^R22ÔUL_R22|msgOF19|T|2.5|123||||
USA||EN
2950 PV1|1|O|Ward|||||||||||||||12345
SPM|1|123456701Êmergency ||PUS||||TOE|LEFT||P||||||200309060805|200309060818||Y|…
Culture^CPT4||||||222221^NURSE^NANCY
||||||222222^PHYSICIAN^^^^DR||||||||MB|P|||||||444642&ROSCOP&Mike^200309070944
ORC|SC|1234567OÊmergency||777Êmergency|A||||200309060818||||||||||||
OBX|1|NM|32761-9^Leukocytes^LN||value|||N|||F|||200309061125||333231^BACK^TERRY
OBX|2|NM|32762-7Êpithelial Cells^LN||value|||N|||F|||200309061125|
|333231^BACK^TERRY
2960 OBX|3|CE|20430-5^Culture^LN||POS^Positive^L|||N|||P|||200309070935|
|333231^BACK^TERRY
OBR|2|12345685Êmergency|PUS0300666^Micro|87088Ôrganism Identification^CPT4|||||||
G||||| ||||||||MB|S
OBR|3|12345686Êmergency|PUS0300666^Micro|87186Ântibiotic
Susceptibility^CPT4||||||| G||||| ||||||||MB|S
2970
Ther
ela
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tshown.
9.5.3.11 LAB-1 (OF  OP)

:Message“St
atuschanged”
Day 3 at 11:32 Mike ROSCOP has performed the clinical validation at 11h30. The
order is completed.
T|2.5|123||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
2980 SPM|1|123456791Êmergency||MSU^Mid Stream
Urine^L|||||||P||||||200309060800|200309060818||Y|…
ORC|SC|12345679Êmergency||777Êmergency|CM||||200309060818||||||||||||
OBR|1|12345679|MSU0309922^Micro|87086Ûrine Microscopy and Culture^CPT4||||||||||||
ORC|SC|12345681Êmergency||777Êmergency|CM||||200309070938|333231^BACK^TERRY||||||
OBR|2|12345679|MSU0309922^Micro|87088Ôrganism Identification^CPT4||||||||||||
2990 ORC|SC|12345682Êmergency||777Êmergency|CM||||200309070938|333231^BACK^TERRY||||||
OBR|3|12345679|MSU0309922^Micro|87186Ântibiotic Susceptibility^CPT4||||||||||||
222222^PHYSICIAN^^^^DR
ORC|SC|12345670||777Êmergency|CM||||200309060818||||||||||||
Culture^CPT4|||||||||||| 222222^PHYSICIAN^^^^DR|
3000 |||||Emergency Ward^^^^^^FI^^ÊW00
OBR|2|12345670|PUS0300666^Micro|87072Ôrganism Identification^CPT4||||||||||||
OBR|3|12345670|PUS0300666^Micro|87186Ântibiotic Susceptibility^CPT4||||||||||||
Ther
ela
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cknowl
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tshown.
9.5.3.12 LAB-3 (OF  ORT)

:Message“St
atuschanged”
Day 3 at 11:32 Mike ROSCOP has performed the clinical validation at 11h30. Final
3010 results are transmitted.
Note: In this message, the OBX-4 (Observation Sub-ID) is used to associate the
results 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 first
organism (E.Coli) whilst the value 2 is used for the second organism (Strepto D).
Although in the following example antibiotic susceptibility results for the two
organisms are grouped under a single OBR segment, it could have been possible to
use one OBR segment for the susceptibility test of each organism.
MSH|^~\&|OF|Microbiology|ORT||200309081132||OUL^R22ÔUL_R22|msgOF21|T|2.5|
3020 123||||USA||EN
PV1|1|O|Ward|||||||||||||||12345
Urine^L|||||||P||||||200309060800|200309060818||Y|…
Culture^CPT4|||||||
|||||222222^PHYSICIAN^^^^DR||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
ORC|SC|12345679Êmergency||777Êmergency|CM||||200309060818||||||||||||Emergency
Ward^^^^^^FI^^ÊW00
3030 TQ1|||||||||R
OBX|1|CE|20453-7Êpithelial Cells^LN||value|||N|||F|||200309061445|
|333231^BACK^TERRY
OBX|2|NM|20455-2^Leukocytes^LN||value|/ml||N|||F|||200309061445|…
OBX|3|NM|32776-7Êrythrocytes^LN||value|/ml||N|||F|||200309061445|…
OBX|4|CE|24124-0^Casts^LN||value|||N|||F|||200309061445||333231^BACK^TERRY
OBX|5|NM|699-9Ôrganism Count^LN||value|/ml||N|||F|||200309061445|…
OBX|6|CE|20430-5^Culture^LN||2ORG^Two Organisms^L|||N|||F|||200309070935|…
||||| ||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
3040 ORC|SC|12345681Êmergency||777Êmergency|CM||||200309070938|333231^BACK^TERRY||||||
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|12345679Êmergency|MSU0309922^Micro|87186Ântibiotic Susceptibility^CPT4
||||||||||||||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
OBX|1|SN|18861-5Âmoxicillin^LN|1|>=0.512|µg/ml||R|||F|||200309081107|…
OBX|2|SN|18864-9Âmpicillin^LN|1|<0.128|µg/ml||I|||F|||200309081107|…
3050 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|18861-5Âmoxicillin^LN|2|value|µg/ml||S|||F|||200309081107|…
OBX|10|SN|18864-9Âmpicillin^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|…
3060 OBX|13|SN|18919-1Êrythromycin^LN|2|value|µg/ml||R|||F|||200309081107|…
OBX|14|SN|18974-6^Rifampicin^LN|2|value|µg/ml||S|||F|||200309081107|…
OBX|15|SN|18938-1^Lincomycin^LN|2|value|µg/ml||R|||F|||200309081107|…
Culture^CPT4||||||222221^NURSE^NANCY
||||||222222^PHYSICIAN^^^^DR||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
ORC|SC|12345670Êmergency||777Êmergency|CM||||200309060818||||||||||||Emergency
Ward^^^^^^FI^^ÊW00
OBX|1|CE|32761-9^Leukocytes^LN||value|||N|||F|||200309060830
3070 OBX|2|CE|32762-7Êpithelial 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|12345670Êmergency|PUS0300666^Micro|87072Ôrganism
Identification^CPT4|||||||||||| ||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
OBX|1|NM|21020-3^Micro organism identified^LN|1|Staph Aureus|||N|||F|
||200309080830|…
3080 OBR|3|12345670Êmergency|PUS0300666^Micro|87186Ântibiotic
Susceptibility^CPT4|||||||||||| ||||||||MB|F|||||||444642&ROSCOP&Mike^200309081130
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|18959-7Ôfloxacin^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|…
3090 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|…
Ther
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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 by
each Transaction on IHE Laboratory Framework.
OML, ORL and OUL message types use a primary trigger event stored in second component of MSH-
9, which describes the message structure (O21, O22, O33, O34, O35, O36), and a secondary trigger
event stored in ORC-1( Or derCo ntr
ol),whi cha ct
ua l
lyist her ea
lwo r
ldt r
iggere vent.The“ Ev ent
type”c olumni sfo rma t
ted“ pri
ma rye vent/s
econdarye vent”.Fort hese,the“ Eventt ype”c olumni s
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 in
the 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 Event HL-7
definition type type Ver2.5
Patient Registration ADT Inpatient/outpatient notice A01 Chapter 3
Registration of an outpatient patient A04
Preadmission of an inpatient A05
Cancel Admit Register Patient A11
Cancel Preadmission of an inpatient A38
Transaction RAD-12: Patient Information Update

Transaction Message Trigger event Event HL-7
definition type type Ver2.5
Patient Information ADT Patient Transfer A02 Chapter 3
Update Patient Discharge A03
Change an Outpatient to Inpatient A06
Change an Inpatient to Outpatient A07
Update Patient Information A08
Canceling Patient Transfert A12
Merge Patient A40
3120
Transaction LAB-1: Placer Order Management

Transaction Message Trigger event Event type HL-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/UA
order 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)
Filler Laboratory Order for multiple orders related to a O33/OC
(OF -> OP) single specimen
Laboratory Order for multiple orders related to a O35/OC
Order Placer ORL General laboratory order response message to any O22/OK
application OML O22/UA
response to order or Laboratory order response message to a multiple O34/OK
battery canceled by order 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
Application ORL General laboratory order response message to any O22/OK
response to a status OML O22/UA
changes Laboratory order response message to a multiple O34/OK
(OP -> OF) order related to a single specimen OML O34/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
Order Filler 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
service replace order 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/RU
single specimen
Laboratory Order for multiple orders related to a O35/RU
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/CA
request 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
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

Send order / service OML Laboratory Order Message O21/SN Chapter 4
number request (Battery Centric)
(OF -> OP) Laboratory Order for multiple orders related to a O33/SN
single specimen
Laboratory Order for multiple orders related to a O35/SN
Acknowledgement ORL General laboratory order response message to any O22/NA or
to order / service OML O22/UA
number request Laboratory order response message to a multiple O34/NA or
(OP -> OF) order related to a single specimen OML O34/UA
Laboratory order response message to a single O36/NA or
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) message 7
(no results available, Unsolicited order oriented observation R24/SC I
procedure message
incomplete)
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, message
validated. Unsolicited order oriented observation R24/SC P
message
Final: All results OUL Unsolicited specimen oriented observation R22/SC F
available, validated message
Unsolicited order oriented observation R24/SC F
message
Correction of final OUL Unsolicited specimen oriented observation R22/SC C
results results message
Unsolicited order oriented observation R24/SC C
message
Deletion of OUL Unsolicited specimen oriented observation R22/SC X
battery/test in a filler message
order Unsolicited order oriented observation R24/SC X
(no results available) message
Addition of a OUL Unsolicited specimen oriented observation R22/SC S
battery/test in an message
order Unsolicited order oriented observation R24/SC S
(but not done) message
Transaction LAB-4: Work Order Management

Order Filler issues OML Laboratory order message O21/NW Chapter
the new order (test Laboratory order for multiple orders related to a O33/NW 4
request) single specimen
(OF -> AM) Laboratory order for multiple orders related to a O35/NW
Automation ORL General laboratory order response message to any O22/OK
Manager responds OML O22/UA
to new order Laboratory order response message to a multiple O34/OK
(AM -> OF) order related to single specimen OML O34/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
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
Laboratory order response message to a single O36RQ
container of a specimen OML O36UM
Order Filler cancels OML Laboratory order message O21/CA

the order (test Laboratory order for multiple orders related to a O33/CA
request) single specimen
(OF -> AM) Laboratory order for multiple orders related to a O35/CA
Automation ORL General laboratory order response message to any O22/CR
Manager responds OML O22/UC
to cancel order Laboratory order response message to a multiple O34/CR
(AM -> OF) order related to single specimen OML O34/UC
Laboratory order response message to a single O36/CR
container of a specimen OML O36/UC
Transaction LAB-5: Test Results Management

Transaction definition Message Trigger event Event OBR-25 HL-7
type type status Ver2.5
Automation Manager OUL I Chapter
transmits the reception Unsolicited Specimen Oriented R22/SC 7
of specimen(s) / Observation Message
container(s)
(no results available, Unsolicited Specimen Container R23/SC I
procedure incomplete) Oriented Observation Message
Unsolicited Order Oriented R24/SC I
Observation Message
Automation Manager OUL
transmits some (or all) Unsolicited Specimen Oriented R22/SC R
of the results Observation Message
not yet validated
Unsolicited Specimen Container R23/SC R
Oriented Observation Message
Unsolicited Order Oriented R24/SC R
Observation Message
transmits the Unsolicited Specimen Oriented R22/SC P
preliminary results Observation Message
(some of results
available, validated) Unsolicited Specimen Container R23/SC P
(AM -> OF) Oriented Observation Message
Unsolicited Order Oriented R24/SC P
Observation Message
transmits the final Unsolicited Specimen Oriented R22/SC F
results Observation Message
(all results available,
validated) Unsolicited Specimen Container R23/SC F
Unsolicited Order Oriented R24/SC F
Observation Message
transmits the correction Unsolicited Specimen Oriented R22/SC C
of final results Observation Message
Unsolicited Specimen Container R23/SC C

Unsolicited Order Oriented R24/SC C
Observation Message
3130
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:Accordi
ngtoHL7v2. 5ta ble0119 ,“ OK”
doesn’ts eemt obeava l
idva luef ora nOMLme ssa
ge,and“RR”i sonlyl e f
tf orba c kward
compa tibili
ty.The reforet heva lue“ SC”( sta
tusc
hanged)ha
sbe enchos en.Thi sha st obe
confirme d.Li kewise,“ UA”( una blet oa c
cept
)does
n’tsee
mtobeava l
idva luef ora nOML
message.
How to represent in HL7 v2.5, the three responsibilities defined in the data model, in a
standard 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 is
postponed 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) and
Reagent Lot Number.
This cycle does not address the transmission of Laboratory global reports in specific format
3150 (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
solutions( spe ci
ficORC/ OBR,MDM me ssagesofHL72. 5c hapt
er9,…)a rea va ilablet o
convey the RID reference but are to be studied.

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GMSIH, HPRIM and JAHIS

Integrating the Healthcare Enterprise

20 Revision 1.2 –Final Text

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

9.2.1 Storyboard .................................................................................................................................... 84

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

1.1 Rationale for the choice of the standard to be used

2.1 The generic IHE Transaction Model

2.2 HL7 Profiling Conventions

2.2.1 Static definition - message level

Receiving applications will be expected to process (save/print/archive/etc.)

If the predicate is satisfied: A compliant sending application shall always

If the predicate is NOT satisfied: A compliant sending application shall NOT

2.2.2 Static definition - segment level

Table 3.2-2: Example: The MSH segment description

2.3 HL7 Implementation Notes

2.3.1 Network Guidelines

2.3.2 Message Granularity

2.3.3 Acknowledgement Modes

2.3.4 ACK: General Acknowledgement Message

2.3.5 IHE Laboratory Technical Framework acknowledgement policies

350 The acknowledgement message to an event-triggered message shall be sent immediately to

360 The acknowledgement message is an application-level acknowledgement. (Note: HL7

Usage of network connections

Initiates network <SB>message<EB><CR>

Usage of network connections

New order Trigger Order status Trigger

Order Placer Order Filler

ORL^OK OML^NW OML^NW ORL^OK

2.3.6 Identifier Data Types

2.3.6.1 EI Data Type

SEQ LEN DT Usage CARD TBL# COMPONENT NAME

Component 1 is required. Either component 2 or both components 3 and 4 are required.

2.3.6.2 CX Data Type

SEQ LEN DT Usage CARD TBL# COMPONENT NAME

3 Common Message Segments for Laboratory Technical

3.1 MSH - Message Header Segment

3.2 MSA - Message Acknowledgement segment

520 Table 3.2-1: MSA - Message Acknowledgement

MSA-1 Acknowledgment Code (ID), required.

MSA-2 Message Control ID (ST), required.

3.3 ERR - Error segment

540 3.4 NTE - Notes and Comment segment

550 NTE-1 Set ID - NTE (SI), required.

3.5 PID - Patient Identification segment

580 3.6 PV1 - Patient Visit segment

3.7 ORC Common Order Segment

Table 3.7-1 : ORC Segment

Table 7.4.1.2.4-1: Supported Order Control Code

Value Description of use

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

3.8 TQ1 - Timing Quantity Segment

3.9 SPM - Specimen Segment

SPM-2 Specimen ID (EIP), conditional.

Value Description Comment

AMN Amniotic fluid

Value Description Comment

BLDA Blood arterial

BBL Blood bag