Page Comparison

ORU R01: Send test results and measurements to PKB

...

Expand

title	Update Behaviour

[[Lab Report]]

Matched on: [[Lab Report.External ID]] as derived from ORC-3.1 or OBR-3.1

When matched: Associated [[Lab Result]] entries are individually matched. Note: if a [[Lab Result]] that was previously provided with the [[Lab Report]] is omitted from this [[Lab Report]], the [[Lab Result]] will be left unmodified. It will not be deleted.

Particular care should be given to panels: if a panel is provided with a status of R then all [[Lab Result]] entries previously stored for the corresponding [[Lab Report]] will be marked as deleted, regardless of whether they were previously included in the panel being redacted or whether they are provided in the current message. If the message contains multiple panels where some but not all have a status of R, then PKB will first delete all results associated with the report ID before following the usual create or update workflow for lab results provided in panels that do not have a status of R.

When not matched: New [[Lab Report]] created.

[[Lab Result]]

Matched on: Results are matched on the test ID (OBX-3, or OBR-4 for textual reports). The test ID is matched only on the first and third components (code and code system), and matching is case sensitive.

When matched: If PKB detects a meaningful difference between the provided and existing lab result content, then the existing [[Lab Result]] is replaced in its entirety with the values provided in this message. A partial update is not performed.

Note: that the existence of more than one version of a given lab result is what determines whether PKB displays a correction indicator in the web interface. The correction indicator is not driven by the status value declared by the sender (e.g. OBX-11), and sending more than one message for a given lab order is not guaranteed to trigger the correction indicator since PKB dedupes updates that do not meaningfully change the content of the lab result.

When not matched: New [[Lab Result]] created.

[[Local Test Type]]

Matched on: The test type is identified by the Source Organisation (to ensure no namespace clashes) along with test code, test coding system and units (all matched case sensitively).

When matched: If an existing [[Local Test Type]] is found, it will be updated with the latest Test Name and Service Name if they differ from what is currently stored. In this way, callers are able to update the display name for their local test types.

When not matched: A new [[Local Test Type]] is created.

[[Measurement]]

Matched on: There is no unique identifier on a [[Measurement]] submitted via HL7, so they cannot be updated.

When matched: N/A

When not matched: New [[Measurement]] created.

Definition

...

Segment
Field
Opt
RP/#
Component
Description
Example
Data Model
(Lab Reports)
Data Model
(Measurements)
21
MSH
Message header. This conforms to PKB's standard definition.
32
PID
Patient identification. This conforms to PKB's standard definition.
43
[ PV1 ]
This is used to include the Hospital Service Code of the observations
54
PV1-10
O
Hospital service. See our notes on code sets for more information on our handling of coded data.
65
PV1-10.1
Hospital service code
[[Lab Report->Lab Result.Specialty]]
76
{
[ ORC ]
Common order
87
ORC-3
C
Filler order number.
At least one of either ORC-3.1 or OBR-3.1 must be provided. It is an error for these values to differ.
98
ORC-3.1
Filler order number
MYORDER0001
[[Lab Report.External ID]]
if OBR-3 was not provided
109
ORC-13
O
Enterer's Location
1110
ORC-13.9
Description
Laboratory 1
[[Lab Report.Enterer Location]]
1211
OBR
Observation request
1312
OBR-3
C
Filler order number.
At least one of either ORC-3.1 or OBR-3.1 must be provided. It is an error for these values to differ.
1413
OBR-3.1
Filler order number
MYORDER0001
[[Lab Report.External ID]]
1514
OBR-4
C
Universal service identifier.
See our notes on code sets for more information on our handling of coded data.
For textual reports, these values override the ones in OBX-3, and as such OBR-4.1 is mandatory.
If a textual report, the test type processing uses OBR-4 instead of OBX-3.
Note that this will mean the service name and the test name might be the same for some textual reports.
1615
OBR-4.1
Service ID
LAB100
The privacy label lookup based on service code is performed regardless of which content pattern was provided. Then additionally:
If a textual report
Stored in
[[Lab Report->Lab Result.Test Code]]
and
[[Lab Report->Lab Result->Local Test Type.Test Code]]
Else
Ignored.
1716
OBR-4.2
Service name
FBC
[[Lab Report->Lab Result.Service]]
and
[[Lab Report->Lab Result->Local Test Type.Service Name]]
Note: the Local ITT only stores the most recently provided service name.
1817
OBR-4.3
Service coding system
WinPath
If a textual report
Stored in
[[Lab Report->Lab Result->Test Coding System]]
and
[[Lab Report->Lab Result->Local Test Type.Test Coding System]]
Else
Ignored.
1918
OBR-4.5
Alternative service name
Full Blood Count
Used instead of OBR-4.2 if OBR-4.2 was not provided.
2019
OBR-7
C
Observation timestamp.
This will be used only if there is no timestamp in OBX-14. It is an error for neither to be provided.
2120
OBR-7.1
Observation timestamp
201505191657
[[Lab Report->Lab Result.Timestamp]]
if OBX-14 was not provided
[[Measurement.Timestamp]]
if OBX-14 was not provided
2221
OBR-14
O
Received timestamp.
2322
OBR-14.1
Received timestamp
201505191521
[[Lab Report->Received Timestamp]]
2423
OBR-16
O
Ordered by.
If present, at least the family name must be given.
[[Lab Report->Lab Result->Source.Source Text]]
[[Measurement->Source.Source Text]]
2524
OBR-16.2
Family name
Foster
2625
OBR-16.3
Given name
John
2726
OBR-16.4
Middle names
Harry
2827
OBR-16.6
Title
Dr
2928
OBR-24
O
Laboratory discipline.
3029
OBR-24.1
Laboratory discipline.
ICU
[[Lab Report->Discipline]]
3130
OBR-25
O
Result status.
If a value of R is provided: any lab results received previously for this report ID will be marked as deleted. OBX segments are not required and will be ignored.
Otherwise: the report is processed as documented.
Note: if the report contains multiple panels where some but not all have a status of R, then PKB will first delete all results associated with the report ID before following the usual create or update workflow for lab results provided in panels that do not have a status of R.
3231
OBR-25.1
Result status
F
3332
{ [ NTE ] }
NTE segments can be used to include comments. NTE segments immediately following the OBR segment will be considered to apply to all results in this message.
3433
NTE-3
O
NTE-3.1
Comment
3534
Comment
This is a comment.
These OBR-level comments will be written to
[[Lab Report->Lab Result.Comments]]
Any OBX-level comments will be appended to the OBR-level comments.
3635
{
OBX
Observation or result
3736
OBX-2
R
Value type.
OBX segments with these value types are silently ignored: AD, CP, DT, DTM, ED, MO, PN, RP, TM, TN, XAD, XCN, XON, XPN, XTN
For SN, a numeric value must be provided in OBX-5.2.
For all other value types, note that:
[[Lab Report->Lab Result.Value]] will be set if the supplied value can be parsed as a number, regardless of the declared value type
[[Lab Report->Lab Result.Value Text]] will be set if the result is non-numeric
[[Lab Report->Lab Result.Comments]] will be set if this is a textual report
3837
OBX-2.1
Value type
NM
3938
OBX-3
R
Observation identifier. See our notes on code sets for more information on our handling of coded data.
4039
OBX-3.1
Test ID.
If this is a textual report, this value will be overridden by OBR-4.1. Otherwise this value must be provided.
If a measurement is being provided, this ID must match one of the predefined values which PKB can accept.
777-3
Stored in
[[Lab Report->Lab Result.Test Code]]
and
[[Lab Report->Lab Result->Local Test Type.Test Code]]
4140
OBX-3.2
Test name
Platelets
Stored in
[[Lab Report->Lab Result->Local Test Type.Test Name]]
Note: the Local ITT only stores the most recently provided test name.
4241
OBX-3.3
Test coding system
If this is a textual report, this value will be overridden by OBR-4.3
Note: PKB will only accept a measurement if this value is one of the following:
( sct, snomed-ct, snomed ct, http://snomed.info/sct, 2.16.840.1.113883.6.96 )
LOINC
Stored in
[[Lab Report->Lab Result->Test Coding System]]
and
[[Lab Report->Lab Result->Local Test Type.Test Coding System]]
4342
OBX-3.5
Alternative test name
Platelet count
Used instead of OBX-3.2 if OBX-3.2 was not provided.
4443
OBX-5
R
Test result value.
If providing an SN value:
OBX-5.1 must be one of: >, <, >=, <=, = (<> is also valid, but not supported. Results with this comparator will be silently ignored.)
OBX-5.2 must be a number
OBX-5.3 and OBX-5.4 are not supported. Results containing a non-empty value for either of these will be silently ignored.
4544
OBX-5.1
Value or comparator.
200
If numerical data, then value set in
[[Lab Report->Lab Result.Value]]
else if textual then value set in
[[Lab Report->Lab Result.Value Text]]
else if a multi-line report then values set in
[[Lab Report->Lab Result.Comments]]
else if SN then map to
[[Lab Report->Lab Result.Comparator]]
[[Measurement.Value]]
If a multi-valued measurement is being supplied, then the next OBX segment will contain the value for
[[Measurement.Value2]]
4645
OBX-5.2
Value
200
If SN, then set in
[[Lab Report->Lab Result.Value]]
4746
OBX-6
O
Units. See our notes on code sets for more information on our handling of coded data.
4847
OBX-6.1
Unit ID
X10TO9L
Used instead of OBX-6.2 if OBX-6.2 was not provided.
4948
OBX-6.2
Unit name.
If providing a measurement, this must match the corresponding PKB permitted value.
10 to 9 per L
Stored in
[[Lab Report->Lab Result->Local Test Type.Units]]
5049
OBX-7
O
Reference range.
Numeric ranges in the format x-y, <x, <=x, >x, >=x are all supported.
If the range does not successfully parse as one of these formats then the contents of this field will be stored as a textual range.
Special cases:
An input of "-" will be treated as if no range had been provided
An input of "0" will be treated as if "0-0" had been provided
5150
OBX-7.1
Reference range
100-300
If a numeric range provided, then the following values will be set appropriately
[[Lab Report->Lab Result.Range Low]]
[[Lab Report->Lab Result.Range Low Inclusive]]
[[Lab Report->Lab Result.Range High]]
[[Lab Report->Lab Result.Range High Inclusive]]
else value set in
[[Lab Report->Lab Result.Textual Range]]
5251
OBX-11
R
Result status. Only values of F and C will be processed. Values of I, O, P or X (which indicate pending or no results) are silently ignored, whilst any other values will cause an error.
5352
OBX-11.1
Result status
F
5453
OBX-13
O
Custom access rules for lab results. Currently supported: "{patientDelay:NUMBERdays}" with any whole number in place of "NUMBER" (no spaces). The patient will see that a lab result has arrived, but the result value will not be revealed until the set number of days past the date/time of observation have passed. If this field is not specified the patient will be able to see their results immediately.
Note: if this OBR group is a textual report spanning multiple OBX segments, the delay must be provided in the first.
5554
OBX-13.1
Custom access rules
{patientDelay:3days}
5655
OBX-14
C
Observation timestamp.
If this is not present, OBR-7 is used instead. It is an error for neither to be provided.
5756
OBX-14.1
Observation timestamp
201505191657
[[Lab Report->Lab Result.Timestamp]]
[[Measurement.Timestamp]]
5857
{ [ NTE ] }
}
}
NTE segments can be used to include comments. NTE segments immediately following an OBX segment will be considered to apply only to the immediately preceding result.
5958
NTE-3
O
Comment
6059
NTE-3.1
Comment
This is a comment.
These OBX-level comments will be appended to
[[Lab Report->Lab Result.Comments]]
after any OBR-level comments.
...

Versions Compared

Old Version 5

New Version 6

Key

ORU R01: Send test results and measurements to PKB

Definition

	Segment	Field	Opt	RP/#	Component	Description	Example	Data Model (Lab Reports)	Data Model (Measurements)
21	MSH					Message header. This conforms to PKB's standard definition.
32	PID					Patient identification. This conforms to PKB's standard definition.
43	[ PV1 ]					This is used to include the Hospital Service Code of the observations
54		PV1-10	O			Hospital service. See our notes on code sets for more information on our handling of coded data.
65					PV1-10.1	Hospital service code		[[Lab Report->Lab Result.Specialty]]
76	{ [ ORC ]					Common order
87		ORC-3	C			Filler order number. At least one of either ORC-3.1 or OBR-3.1 must be provided. It is an error for these values to differ.
98					ORC-3.1	Filler order number	MYORDER0001	[[Lab Report.External ID]] if OBR-3 was not provided
109		ORC-13	O			Enterer's Location
1110					ORC-13.9	Description	Laboratory 1	[[Lab Report.Enterer Location]]
1211	OBR					Observation request
1312		OBR-3	C			Filler order number. At least one of either ORC-3.1 or OBR-3.1 must be provided. It is an error for these values to differ.
1413					OBR-3.1	Filler order number	MYORDER0001	[[Lab Report.External ID]]
1514		OBR-4	C			Universal service identifier. See our notes on code sets for more information on our handling of coded data. For textual reports, these values override the ones in OBX-3, and as such OBR-4.1 is mandatory.		If a textual report, the test type processing uses OBR-4 instead of OBX-3. Note that this will mean the service name and the test name might be the same for some textual reports.
1615					OBR-4.1	Service ID	LAB100	The privacy label lookup based on service code is performed regardless of which content pattern was provided. Then additionally: If a textual report Stored in [[Lab Report->Lab Result.Test Code]] and [[Lab Report->Lab Result->Local Test Type.Test Code]] Else Ignored.
1716					OBR-4.2	Service name	FBC	[[Lab Report->Lab Result.Service]] and [[Lab Report->Lab Result->Local Test Type.Service Name]] Note: the Local ITT only stores the most recently provided service name.
1817					OBR-4.3	Service coding system	WinPath	If a textual report Stored in [[Lab Report->Lab Result->Test Coding System]] and [[Lab Report->Lab Result->Local Test Type.Test Coding System]] Else Ignored.
1918					OBR-4.5	Alternative service name	Full Blood Count	Used instead of OBR-4.2 if OBR-4.2 was not provided.
2019		OBR-7	C			Observation timestamp. This will be used only if there is no timestamp in OBX-14. It is an error for neither to be provided.
2120					OBR-7.1	Observation timestamp	201505191657	[[Lab Report->Lab Result.Timestamp]] if OBX-14 was not provided	[[Measurement.Timestamp]] if OBX-14 was not provided
2221		OBR-14	O			Received timestamp.
2322					OBR-14.1	Received timestamp	201505191521	[[Lab Report->Received Timestamp]]
2423		OBR-16	O			Ordered by. If present, at least the family name must be given.		[[Lab Report->Lab Result->Source.Source Text]]	[[Measurement->Source.Source Text]]
2524					OBR-16.2	Family name	Foster
2625					OBR-16.3	Given name	John
2726					OBR-16.4	Middle names	Harry
2827					OBR-16.6	Title	Dr
2928		OBR-24	O			Laboratory discipline.
3029					OBR-24.1	Laboratory discipline.	ICU	[[Lab Report->Discipline]]
3130		OBR-25	O			Result status. If a value of R is provided: any lab results received previously for this report ID will be marked as deleted. OBX segments are not required and will be ignored. Otherwise: the report is processed as documented. Note: if the report contains multiple panels where some but not all have a status of R, then PKB will first delete all results associated with the report ID before following the usual create or update workflow for lab results provided in panels that do not have a status of R.
3231					OBR-25.1	Result status	F
3332	{ [ NTE ] }					NTE segments can be used to include comments. NTE segments immediately following the OBR segment will be considered to apply to all results in this message.
3433		NTE-3	O		NTE-3.1	Comment
3534						Comment	This is a comment.	These OBR-level comments will be written to [[Lab Report->Lab Result.Comments]] Any OBX-level comments will be appended to the OBR-level comments.
3635	{ OBX					Observation or result
3736		OBX-2	R			Value type. OBX segments with these value types are silently ignored: AD, CP, DT, DTM, ED, MO, PN, RP, TM, TN, XAD, XCN, XON, XPN, XTN For SN, a numeric value must be provided in OBX-5.2. For all other value types, note that: [[Lab Report->Lab Result.Value]] will be set if the supplied value can be parsed as a number, regardless of the declared value type [[Lab Report->Lab Result.Value Text]] will be set if the result is non-numeric [[Lab Report->Lab Result.Comments]] will be set if this is a textual report
3837					OBX-2.1	Value type	NM
3938		OBX-3	R			Observation identifier. See our notes on code sets for more information on our handling of coded data.
4039					OBX-3.1	Test ID. If this is a textual report, this value will be overridden by OBR-4.1. Otherwise this value must be provided. If a measurement is being provided, this ID must match one of the predefined values which PKB can accept.	777-3	Stored in [[Lab Report->Lab Result.Test Code]] and [[Lab Report->Lab Result->Local Test Type.Test Code]]
4140					OBX-3.2	Test name	Platelets	Stored in [[Lab Report->Lab Result->Local Test Type.Test Name]] Note: the Local ITT only stores the most recently provided test name.
4241					OBX-3.3	Test coding system If this is a textual report, this value will be overridden by OBR-4.3 Note: PKB will only accept a measurement if this value is one of the following: ( sct, snomed-ct, snomed ct, http://snomed.info/sct, 2.16.840.1.113883.6.96 )	LOINC	Stored in [[Lab Report->Lab Result->Test Coding System]] and [[Lab Report->Lab Result->Local Test Type.Test Coding System]]
4342					OBX-3.5	Alternative test name	Platelet count	Used instead of OBX-3.2 if OBX-3.2 was not provided.
4443		OBX-5	R			Test result value. If providing an SN value: OBX-5.1 must be one of: >, <, >=, <=, = (<> is also valid, but not supported. Results with this comparator will be silently ignored.) OBX-5.2 must be a number OBX-5.3 and OBX-5.4 are not supported. Results containing a non-empty value for either of these will be silently ignored.
4544					OBX-5.1	Value or comparator.	200	If numerical data, then value set in [[Lab Report->Lab Result.Value]] else if textual then value set in [[Lab Report->Lab Result.Value Text]] else if a multi-line report then values set in [[Lab Report->Lab Result.Comments]] else if SN then map to [[Lab Report->Lab Result.Comparator]]	[[Measurement.Value]] If a multi-valued measurement is being supplied, then the next OBX segment will contain the value for [[Measurement.Value2]]
4645					OBX-5.2	Value	200	If SN, then set in [[Lab Report->Lab Result.Value]]
4746		OBX-6	O			Units. See our notes on code sets for more information on our handling of coded data.
4847					OBX-6.1	Unit ID	X10TO9L	Used instead of OBX-6.2 if OBX-6.2 was not provided.
4948					OBX-6.2	Unit name. If providing a measurement, this must match the corresponding PKB permitted value.	10 to 9 per L	Stored in [[Lab Report->Lab Result->Local Test Type.Units]]
5049		OBX-7	O			Reference range. Numeric ranges in the format x-y, <x, <=x, >x, >=x are all supported. If the range does not successfully parse as one of these formats then the contents of this field will be stored as a textual range. Special cases: An input of "-" will be treated as if no range had been provided An input of "0" will be treated as if "0-0" had been provided
5150					OBX-7.1	Reference range	100-300	If a numeric range provided, then the following values will be set appropriately [[Lab Report->Lab Result.Range Low]] [[Lab Report->Lab Result.Range Low Inclusive]] [[Lab Report->Lab Result.Range High]] [[Lab Report->Lab Result.Range High Inclusive]] else value set in [[Lab Report->Lab Result.Textual Range]]
5251		OBX-11	R			Result status. Only values of F and C will be processed. Values of I, O, P or X (which indicate pending or no results) are silently ignored, whilst any other values will cause an error.
5352					OBX-11.1	Result status	F
5453		OBX-13	O			Custom access rules for lab results. Currently supported: "{patientDelay:NUMBERdays}" with any whole number in place of "NUMBER" (no spaces). The patient will see that a lab result has arrived, but the result value will not be revealed until the set number of days past the date/time of observation have passed. If this field is not specified the patient will be able to see their results immediately. Note: if this OBR group is a textual report spanning multiple OBX segments, the delay must be provided in the first.
5554					OBX-13.1	Custom access rules	{patientDelay:3days}
5655		OBX-14	C			Observation timestamp. If this is not present, OBR-7 is used instead. It is an error for neither to be provided.
5756					OBX-14.1	Observation timestamp	201505191657	[[Lab Report->Lab Result.Timestamp]]	[[Measurement.Timestamp]]
5857	{ [ NTE ] } } }					NTE segments can be used to include comments. NTE segments immediately following an OBX segment will be considered to apply only to the immediately preceding result.
5958		NTE-3	O			Comment
6059					NTE-3.1	Comment	This is a comment.	These OBX-level comments will be appended to [[Lab Report->Lab Result.Comments]] after any OBR-level comments.