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18.4.118 ORU Unsolicited Observation Message (Event R01) (7.3.1)

The ORU message is for transmitting observational results, including lab, clinical or other observations, to other systems.. The OUL message is designed to accommodate the laboratory processes of laboratory automation systems.

With the segment (OBX) defined in this chapter, and the OBR defined in Chapter 4, one can construct almost any clinical report as a multi-level hierarchy, with the PID segment defined in Chapter 3 at the upper level, an order record (OBR) at the next level with one or more observation records (OBX), followed by the specimen information (SPM) and one or more observations (OBX) directly associated with the specimen.

One result segment (OBX) is transmitted for each component of a diagnostic report, such as an EKG or obstetrical ultrasound or electrolyte battery.

The CTD segment in this trigger is used to transmit temporary patient contact details specific to this order.

The Device segment (DEV) provides additional device information for a device referenced in one or more of the PRT segments in the message (using PRT-10 Participation Device to match DEV-2 Unique Device Identifier or PRT-22 Participation Device Type using DEV-3 Device Type).

Segment Cardinality Implement Status
ORU^R01^ORU_R01
MSH

Message Header

[1..1] SHALL
ARV

Access Restriction

 
UAC

User Authentication Credential Segment

[0..1]  
PATIENT_RESULT [1..*] SHALL
PATIENT [0..1]  
PID

Patient Identification

[1..1] SHALL
PD1

Patient Additional Demographic

[0..1]  
PRT

Participation Information

 
OH1

Person Employment Status

 
OH2

Past or Present Job

 
OH3

Usual Work

[0..1]  
OH4

Combat Zone Work

 
NTE

Notes and Comments

 
NEXT_OF_KIN  
NK1

Next of Kin / Associated Parties

[1..1] SHALL
OH2

Past or Present Job

 
OH3

Usual Work

[0..1]  
ARV

Access Restriction

  B
PATIENT_OBSERVATION  
OBX

Observation/Result

[1..1] SHALL
PRT

Participation Information

 
VISIT [0..1]  
PV1

Patient Visit

[1..1] SHALL
PV2

Patient Visit - Additional Information

[0..1]  
PRT

Participation Information

 
INSURANCE  
IN1

Insurance

[1..1] SHALL
IN2

Insurance Additional Information

[0..1]  
IN3

Insurance Additional Information, Certification

[0..1]  
ORDER_OBSERVATION [1..*] SHALL
COMMON_ORDER [0..1]  
ORC

Common Order

[1..1] SHALL
PRT

Participation Information

 
ORDER_DOCUMENT [0..1]  
OBX

Observation/Result

[1..1] SHALL
PRT

Participation Information

 
TXA

Transcription Document Header

[1..1] SHALL
OBR

Observation Request

[1..1] SHALL
NTE

Notes and Comments

 
OBSERVATION_PARTICIPATION  
PRT

Participation Information

[1..1] SHALL
DEV

Device

 
TIMING_QTY  
TQ1

Timing/Quantity

[1..1] SHALL
TQ2

Timing/Quantity Relationship

 
CTD

Contact Data

[0..1]  
OBSERVATION  
OBX

Observation/Result

[1..1] SHALL
PRT

Participation Information

 
NTE

Notes and Comments

 
FT1

Financial Transaction

 
CTI

Clinical Trial Identification

 
SPECIMEN  
SPM

Specimen

[1..1] SHALL
SPECIMEN_OBSERVATION  
OBX

Observation/Result

[1..1] SHALL
PRT

Participation Information

 
DEVICE  
DEV

Device

[1..1] SHALL
OBX

Observation/Result

 
DSC

Continuation Pointer

[0..1]  

 

ORU_R01

MSH-15 MSH-16 Immediate ACK Application Ack
Blank Blank - ACK^R42^ACK
Blank Blank - ACK^R43^ACK
Blank Blank - ORA^R41^ORA_R41
Blank Blank - ACK^R01^ACK
NE NE - -
NE NE - -
NE NE - -
NE NE - -
NE AL, SU, ER - ACK^R01^ACK
NE AL, SU, ER - ORA^R41^ORA_R41
NE AL, SU, ER - ACK^R42^ACK
NE AL, SU, ER - ACK^R43^ACK
AL, SU, ER AL, SU, ER ACK^R43^ACK ACK^R43^ACK
AL, SU, ER AL, SU, ER ACK^R01^ACK ACK^R01^ACK
AL, SU, ER AL, SU, ER ACK^R42^ACK ACK^R42^ACK
AL, SU, ER AL, SU, ER ACK^R40^ACK ORA^R41^ORA_R41
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Note: The ORC is permitted but not required in this message. Any information that could be included in either the ORC or the OBR must be included in the OBR on reporting. Notice also that the ORU (and the QRY) messages accommodate reports about many patients.

Many report headers (OBR) may be sent beneath each patient segment, with many separate observation segments (OBX) related to the order / observation request beneath each OBR. OBX segments that are related to specimens immediately follow the SPM segments. Note segments (NTE) may be inserted at different locations in the message. The note segment applies to the entity that immediately precedes it, i.e., the patient if it follows the PID segment, the observation request if it follows the OBR segment, and the individual result if it follows the OBX segment.

Segment Cardinality Implement Status
ACK^R01^ACK
MSH

Message Header

[1..1] SHALL
SFT

Software Segment

 
MSA

Message Acknowledgment

[1..1] SHALL
ERR

Error

 

 

ACK

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There is not supposed to be an Application Level acknowledgement to an Application Level Acknowledgement message. In Enhanced Mode, MSH-16 SHALL always be set to NE (Never).