J Japanese A Association of HHealthcare I Information J A H I S Ver. 1.0 S Systems Industry
JAHIS Ver. 1.0 1993 ( ) (MEDIS-DC) ( ) 1 30 (JAHIS) 6 ( ) 7 8 WG DRAFT 9 HL7 JAHIS Ver.1.0 1998 6 Copyright 1998 JAHIS Copyright 1998 MML/MERIT-9
1 1 2 HL7 2 3 3 4 4 4 1 HL7 4 4 2 4 4 3 5 4 4 ORM ORU 6 5 8 5 1 8 5 2 9 5 3 11 5 4 12 5 5 / 23 5 6 28 6 32 6 1 6 2 MSH 32 NTE 35 6 3 PID 36 6 4 PV1 39 6 5 AL1 44 6 6 ORC 45 6 7 OBR 56 6 8 OBX 63 7 MERIT 9 69
1. JIS 1985 JCCLS(Japan Committee for Clinical Laboratory Standards) 1962 1990 8 8 9 1994 1997 10 1993 MEDIS-DC ( ) ( ) ASTM E-1238 HL7 HL7 Ver2.3 HL7 Ver2.3 HL7 HL7 Ver2.3 JAHIS Ver. 1.0 HL7 Ver2.3 4 7 2 3 Copyright 1998 JAHIS V1.0 1
2. HL7 (HL7 ) OSI 7 HL7 ( ) 1960 1970-85 1985 (HL7 ) 1987 3 3-4 V1.0 V1.0 1987 10 1988 9 V2.0 1990 V2.1 1991 ANSI 1992 HISPP(Healthcare Informatics Standards Planning Panel) 1994 ANSI 1994 V2.2 1997 V2.3 V3.0 (HL7 ) HL7 HL7 HL7 1500 (HL7 ) HL7 OSI 7 ( ) HL7 V2.1 V2.2 V2.3 HL7 ID ( ) ( ( ) ( ) ( ) ASTM E1238 HL7 ANSI HISPP ( HISB) NCPDP( ), ACR/NEMA( DICOM), IEEE MEDIX( ), ASTM( ), ASC X12( ) CEN-TC251(European Committee for Standardization Technical Committee 251) Copyright 1998 JAHIS V1.0 2
( HL7 ) HL7 1998 7 HL7 Merit 9 Copyright 1998 JAHIS V1.0 3
3. Trigger Event HL7 Message 1 ADT( ) 3 Segment(record) 1 ( ) ID 3 OBR OBX Field Field components ( ) Message Delimiters Placer(Requestor) ( ) X Filler(Producer) ( ) ( ) ( ) Battery 1 Na+ K+ Cl- HCO 3 - (HL7 ) 1 ( ) Copyright 1998 JAHIS V1.0 4
4. 4.1 HL7 ( ) ( (MSH) ( ( ) 4.2 (ORM) ORM ( ) ORM General Order Message MSH Message Header [{NTE} ] Notes and Comments (for Header) PID Patient Identification [{NTE} ] Notes and Comments (for Patient ID) [ PV1 Patient Visit [ PV2 ] ] Patient Visit 2 [ { AL1 } ] Allergy { ORC Common Order OBR Observation Request [{ NTE } ] Notes and Comments (for OBR) [ { OBX Observation/Result [{ NTE } ] Notes and Comments (for Results) } ] } [ ] { } MSH ( ) PID 1 1 MSH Copyright 1998 JAHIS V1.0 5
ORC 1 (OBR) 1 ORC OBR OBX ORC 1 ORC OBR OBX ORC OBR OBX OBR OBX OBR OBX GOT,GPT,HBs OBR 100g OBX, 30 (OBR-4/OBX-3) (OBR-15) OBX 4.3 (ORU) ORU - ORU Observational Results MSH Message Header { PID Patient Identification [{ NTE } ] Notes and comments( for PID) [ PV1 ] Patient Visit { [ ORC ] Order common OBR Observations Report ID [{ NTE } ] Notes and comments( for OBR) [ { OBX Observation/Result [{ NTE } ] Notes and comments( for OBX) } ] } } [ ] { } MSH PID 1 1 PID OBR Copyright 1998 JAHIS V1.0 6
(OBR-4/OBX-3) OBX 1 ID OBX ORC 4.4 ORM ORU HL7 V2.3 ORM Seagaia LAB V2.3 mn123 5/23 MSH ^~\& Seagaia LAB 19970523 ORM^O01 mn123 T 2.3 ~JIS X 0208 JP JIS X 0202 Merit-9 NTE P Merit-9 Example Order 1950 5 23 OPC-001 IDPID001 PID OPC-001 PID001 OTSUKA^TARO^^^^L^A~ ^ ^^^^L^I~ ^ ^^^^L^P 19500523 M PV1 O ^ ^ ^^^^L^I 1965.1.1 AL1 1 DA ^ MO 19650101 5/23 9:30 (GOT,GPT,LDH-ISO) (,30,60,120 ) 0523001,0523002,0523003 0523001 OAL 5 23 1,30,60,120 4 ORC NW 0523001 0523001 199705230930 OBR 0523001 9A100^ ^JC9 19970523 ^ ^ ^^^^L^I EC ORC NW 0523002 0523001 199705230930 OBR 0523002 ^ set^l 19970523 19970523 023 ^ ^ ^^^^L^I OAL 1 OBX NM 3B0350000023272^GOT^JC9 D OBX NM 3B0450000023272^GPT^JC9 D OBX NM 3B0550000023233^LDH-ISO^JC9 D ORC NW 0523003 0523001 199705230930 OBR 0523003 ^OGTT^L 19970523 19970523 022^ ^ ^ ^^^^L^I OAL 4 OBX NM 3D0101000022272^ ^JC9 D OBX NM 3D0101030022272^ 30M^JC9 D OBX NM 3D0101060022272^ 60M^JC9 D OBX NM 3D0101120022272^ 120M^JC9 D HL7 V2.3 ORU LAB Seagaia V2.3 mn256 5/25 MSH ^~\& LAB Seagaia 19970525 ORU^R01 mn256 T 2.3 ~JIS X 0208 JP JIS X 0202 Merit-9 NTE L Merit-9 Example Result 1950 5 23 OPC-001 IDPID001 PID OPC-001 PID001 OTSUKA^TARO^^^^L^A~ ^ ^^^^L^I~ ^ ^^^^L^P 19500523 M 5/23 0523001 5/23 10:00 OBR 0523001 9A100^ ^JC9 19970523 199705231000 ^ ^ ^^^^L^I EC F ^ OBX TX 9A100&IMP^ ^JC9 AA F 1 4 OAL 5/24 GOT 50U 6-28 GPT 5U 3-9 LDH-ISO 10,30,20,40% OAL 80,150,100,60mg/dl 1000 2000 OBR 0523002 123456701^OAL ^ set^l 19970523 19970523 19970524 023 ^ ^ ^^^^L^I 1000^YEN OAL F ^ 1 OBX NM 3B035000002327201^GOT^JC9 50 U 6-28 H N F OAL Copyright 1998 JAHIS V1.0 7
OBX NM 3B045000002327201^GPT^JC9 5 U 3-9 N F OAL OBX ST 3B055000002323300^LDH-ISO^JC9 F OAL OBX NM 3B055000002323351^LDH1^JC9 10 % F OAL OBX NM 3B055000002323352^LDH2^JC9 30 % F OAL OBX NM 3B055000002323353^LDH3^JC9 20 % F OAL OBX NM 3B055000002323354^LDH4^JC9 40 % F OAL OBR 0523003 123456702^OAL ^OGTT^L 19970523 19970523 19970524 022^ ^ ^ ^^^^L^I 2000^YEN OAL F ^ 4 OBX NM 3D010100002227201^ ^JC9 80 mg/dl 60-100 N F OAL OBX NM 3D010103002227201^ 30M^JC9 150 mg/dl 90-200 N F OAL OBX NM 3D010106002227201^ 60M^JC9 100 mg/dl 80-160 N F OAL OBX NM 3D010112002227201^ 120M^JC9 60 mg/dl 50-100 N F OAL 3 ORM message: MSH... PID... ORC NW A226677^PC 946281^PC N 3^QAM 198801121132 P123^AQITANE^ELLINORE^""^""^""^MD 4EAST<CR> OBR 9A100^EKG REPORT^JC9 P030^SMITH^MARTIN^""^""^""^MD 3^QAM<CR> MSH... PID... ORC NW... // New order. OBR P42^PC 8A020000098271^Creatinine Clearance^JC9... OBX ST 1010.1^Body Weight 62 kg<cr> OBX ST 1010.3^Height 190 cm<cr> ORC NW... // Next order.... Copyright 1998 JAHIS V1.0 8
5. 5.1 OBR-4,OBX-3 10 1 (JLAC10)1997.10 ( ) : [ ] IgE ZTT ( ) : [ ] ( ) : [ ]001 004 018 022 023 ( ) : [ ] ( ) : [ ] 01 11 28 3B025 CK 51 BB 52 MB 53 MM 54 5F190 1430 023 041 CF 141 151 ( ) 05 HSV 1 ( ) 51 HSV 2 ( ) 52 5 15 17 HL7 OBR/OBX ( ) ( http://www.alles.co.jp/~jscp1/ ) Copyright 1998 JAHIS V1.0 9
5.2 OBR-15 1. 2. ( ) (001) (004) (018) (022) (023) 3. ( (019) 4. (098) [ ] 001 ( ) 040 ( ) 070 *( ) 002 041 071 * 003 042 072 * 004 043 073 * 005 044 074 * 006 045 075 * 007 046 008 047 077 009 048 078 010 049 081 ( ) 011 082 012 050 ( ) 083 015 051 085 052 086 ( ) 017 ( ) 053 087 018 054 088 019 ( ) 055 089 020 056 090 021 059 091 022 060 092 023 061 093 024 062 094 ( ) 025 063 095 026 064 096 027 065 097 028 066 098 029 067 099 030 068 ( ) 031 069 032 033 034 036 037 038 039 Copyright 1998 JAHIS V1.0 10
( ) 200 990 3 201 1or 6 456 2or 7 252 3or 8 667 4or 9 553 478 334 719 ( ) ( ) 200 ( ) 600 205 400 605 210 405 610 410 615 220 415 620 225 420 ( ) 230 425 650 430 655 250 435 660 255 665 260 ( ) 670 265 450 695 270 455 275 700 280 ( ) 705 ( ) ( ) 460 710 300 465 715 305 470 720 310 480 725 315 485 730 ( ) 735 330 ( ) 740 335 500 795 340 510 ( ) 345 515 800 350 805 355 ( ) 810 365 530 815 535 820 370 545 825 375 ( ) 830 380 550 895 385 555 390 560 900 395 565 910 570 920 575 930 580 990 585 590 595 ( ) 991 X Copyright 1998 JAHIS V1.0 11
5.3 Message Delimiters (16 0D) MSH 4 MSH MSH 2-1 Figure 2-1. Delimiter values - <cr> hex 0D - 2 1 ^ 2 ~ 3 \ TX FT 4 & Segment Terminator ASCII (16 0D) Field Separator HL7 ID MSH 4 Component Separator MSH ^ Repetition Separator MSH ~ Subcomponent Separator MSH & Escape Character (TX FT ) TX FT MSH 3 \ ASCII ASCII Copyright 1998 JAHIS V1.0 12
5.4 Data types 2-2. HL7 data types( ) Data type Data Type Name Notes/Format Alphanumeric ST String TX Text data FT Formatted text Numerical CQ Composite quantity with units <quantity (NM)> ^ <units (CE)> MO Money <quantity (NM)> ^ <denomination (ID)> NM Numeric SI Sequence ID SN Structured numeric <comparator> ^ <num1 (NM)> ^ <separator/suffix> ^ <num2 (NM)> Identifier ID Coded values for HL7 tables IS Coded value for user-defined tables HD Hierarchic designator <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)> Used only as part of EI and other data types. EI Entity identifier <entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)> RP Reference pointer <pointer (ST) > ^ < application ID (HD)> ^ <type of data (ID)> ^ <subtype (ID)> PL Person location <point of care (IS )> ^ <room (IS )> ^ <bed (IS)> ^ <facility (HD)> ^ < location status (IS )> ^ <person location type (IS)> ^ <building (IS )> ^ <floor (IS )> ^ <location description (ST)> PT Processing type <processing ID (ID)> ^ <processing mode (ID)> Date/Time DT Date YYYY[MM[DD]] TM Time HH[MM[SS[.S[S[S[S]]]]]][+/-ZZZZ] TS Time stamp YYYY[MM[DD[HHMM[SS[.S[S[S[S]]]]]]]][+/-ZZZZ] ^ <degree of precision> Code Values CE Coded element <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)> CF Coded element with formatted values <identifier (ID)> ^ <formatted text (FT)> ^ <name of coding system (ST)> ^ <alternate identifier (ID)> ^ <alternate formatted text (FT)> ^ <name of alternate coding system (ST)> CK Composite ID with check digit <ID number (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> CX XCN Extended composite ID with check digit Extended composite ID number and name <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD) )> ^ <identifier type code (IS)> ^ < assigning facility (HD) <ID number (ST)> ^ <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code (ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ <identifier type code (IS)> ^ <assigning facility (HD)> Generic CM Composite No new CM s are allowed after HL7 Version 2.2. Hence there are no new CM s in Version 2.3. Demographics XAD Extended address <street address (ST)> ^ <other designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code (ST)> ^ <country (ID)> ^ < address type (ID)> ^ <other geographic designation (ST)> ^ <county/parish code (IS)> ^ <census tract (IS)> XPN Extended person name <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <name type code (ID) > XON XTN Extended composite name and ID number for organizations Extended telecommunications number <organization name (ST)> ^ <organization name type code (IS)> ^ <ID number (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ <assigning authority (HD)> ^ <identifier type code (IS)> ^ <assigning facility ID (HD)> [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)> Waveform CD Channel definition For waveform data only, see Chapter 7, Section 7.15.3. <channel identifier (*)> ^ <channel number (NM)> & <channel name (ST)>> ^ <electrode names (*) > ^ Copyright 1998 JAHIS V1.0 13
<channel sensitivity/units (*) > ^ <calibration parameters (*)> ^ <sampling frequency (NM)> ^ <minimum/maximum data values (*)> MA Multiplexed array For waveform data only, see Chapter 7, Section 7.15.2. <sample 1 from channel 1 (NM)> ^ <sample 1 from channel 2 (NM)> ^ <sample 1 from channel 3 (NM)>...~<sample 2 from channel 1 (NM)> ^ <sample 2 from channel 2 (NM)> ^ <sample 2 from channel 3 (NM)>...~ NA Numeric array For waveform data only, see Chapter 7, Section 7.15.1. <value1 (NM)> ^ <value2 (NM)> ^ <value3 (NM)> ^ <value4 (NM)> ^... ED Encapsulated data Supports ASCII MIME-encoding of binary data. <source application (HD) > ^ <main type of data (ID)> ^ <data subtype (ID)> ^ <encoding (ID)> ^ <data (ST)> Records PPN Performing person time stamp: <ID number (ST)> ^ <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code(id)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID )> ^ <identifier type code (IS)> ^ <assigning facility (HD)> ^ < date/time action performed (TS)> Time Series: TQ Timing/quantity For timing/quantity specifications for orders, see Chapter 4, Section 4.4. <quantity (CQ)> ^ <interval (*)> ^ <duration (*)> ^ <start date/time (TS)> ^ <end date/time (TS)> ^ <priority (ID)> ^ <condition (ST)> ^ <text (TX)> ^ <conjunction (ID)> ^ <order sequencing (*)> * for subcomponents of these elements please refer to the definition in the text. Data types ( ) ST ( )ASCII (20 7E 16 ) almost any data at all TX leading spaces are allowed. TX ( CR/LF ) FT (ST) FT (65k ) \.sp\(skip one vertical line) CQ < >^< > 1 2 ISO+ ANSI 123.7^kg kilograms is an ISO unit 150^lb&&ANSI+ weight in pounds is a customary US unit defined within ANSI+. MO Components:<quantity (NM)> ^ <denomination (ID)> 1 2 Copyright 1998 JAHIS V1.0 14
ISO-4217 MSH-17 99.50^USD USD ISO 4217 NM ASCII ( ) 999-123.792 01.20 1.2 2 ( ) ( ) ASCII <12 SI ID NM SN Components:<comparator (ST)> ^ <num1 (NM)> ^ <separator/suffix / (ST)> ^ <num2 (NM)> > < >= <= = <> = <num1> <num2> / - <num1> - <num2> <num1> <= x <= <num2> X num1 num2 / - + /. : >^100 (greater than 100) ^100^-^200 (equal to range of 100 through 200) ^1^:^228 (ratio of 1 to 128, e.g., the results of a serological test) ^2^+ (categorical response, e.g., occult blood positivity) ID ST ID IS ST IS HL7 HD Components:<namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)> HD UID HD HL7 IS HD 1 2 3 3 2 HD 2 ID(UID) 3 ID (UID ) UID UID UID UID 1 UID( 2 ) 3 ID Value DNS 0301 ID ASCII Copyright 1998 JAHIS V1.0 15
Value GUID UUID HCD CEN (DICOM ) HL7 HL7 ISO L M N base64 ASCII base64 UUID DCE ID x400 X400 MHS ID x500 X500 1.2.34.4.1.5.1.5.1,1.13143143.131.3131.1^ISO 14344.14144321.4122344.14434.654^GUID falcon.iupui.edu^dns 40C983F09183B0295822009258A3290582^RANDOM LAB1 Local use only: an HD that looks like an IS data type. PathLab^UCF.UC^L A locally defined HD in which the middle component is itself structured. This can be considered the combination of 'PathLab' with the locally defined UID system "L". LAB1^1.2.3.3.4.6.7^ISO An HD with an ISO "Object Identifier" as a suffix, and a locally defined system name. ^1.2.344.24.1.1.3^ISO An HD consisting only of an ISO UID. EI Components:<entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID (ST)> ^ < universal ID type (ID)> S) 2 4 (HD) 3 EI EI 2 4 2.8.18 HD HL7 1 2 4 RP Components:<pointer (ST) > ^ < application ID (HD)> ^ <type of data (ID)> ^ <subtype (ID)> ST ID HD ( ) ID HL7 0191 0191 Value Image Image data (HL7 v 2.3) Audio Audio data (HL7 v 2.3) Application Other application data, typically uninterpreted binary data (HL7 v 2.3) HL7 0291 Copyright 1998 JAHIS V1.0 16
Value TIFF PICT DICOM FAX JOT BASIC Octet-stream PostScript JPEG GIF HTML RTF 0291 - Subtype of referenced data TIFF image data PICT format image data Digital Imaging and Communications in Medicine Facsimile data Electronic ink data (Jot 1.0 standard) ISDN PCM audio data Uninterpreted binary data PostScript program Joint Photographic Experts Group Graphics Interchange Format Hypertext Markup Language Rich Text Format PL Components:<point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ <location status (IS) > ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)> HL7 < (IS)> ^ (HD)> ^ < (IS)> ^ < (IS)> ^ < (IS)> ^ < (IS)> ^ < (ST)> ^ < (IS)> PT Components:<processing ID (ID)> ^ <processing mode (ID)> HL7 HL7 ID HL7 0103 ID HL7 0207 DT YYYYLLDD 19880704 TM 24 HHMM[SS[.SSSS]][+/-ZZZZ] (SS) ( ) TM MSH 0000 235959+1130 1 second before midnight in a time zone eleven and half hours ahead of Universal Coordinated Time (i.e., east of Greenwich). 0800 Eight AM, local time of the sender. 093544.2312 44.2312 seconds after Nine thirty-five AM, local time of sender. TS YYYYLLDD[HHMM[SS[.SSSS]]][+/-ZZZZ]^< > Copyright 1998 JAHIS V1.0 17
HHMM 0000 (0 0 ) HL7 ISO 8824-1987(E) (Y = L = D = H = M = S = ) : 17760704010159-0600 1:01:59 on July 4, 1776 in the Eastern Standard Time zone. 17760704010159-0500 1:01:59 on July 4, 1776 in the Eastern Daylight Saving Time zone. 198807050000 Midnight of the night extending from July 4 to July 5, 1988 in the local time zone of the sender. 198807050000^D Same as prior example, but precision extends only to the day. Could be used for a birthdate.( 19880705 ) HL7 HL7 12 11 11:00 12 12 ( )12 11 HL7 CM CM HL7 CE < & & > HL7 HL7 HL7 / CE Components:<identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)> 54.21^Laparoscopy^I9^42112^^AS4 F-11380^CREATININE^I9^2148-5^CREATININE^LN 6 <text> ( ) X (ST) ICD-9 ICD-10 SNOMED HL7 nnnn HL7nnnn 3 Copyright 1998 JAHIS V1.0 18
2 CE ( ) CF Components:<identifier (ID)> ^ <formatted text (FT)> ^ <name of coding system (ST)> ^ <alternate identifier (ID)> ^ <alternate formatted text (FT)> ^ <name of alternate coding system (ST)> ( X ) 2 5 CE OBX CF 71020^CXR^CPMC 79989^ \H\:\N\\.sp\\ti+4\Heart is not enlarged. There is no evidence of pneumonia, effusion, pneumothorax or any masses.\.sp+3\\h\impression:\n\\.sp\\.ti+4\negative chest.^cpmc CK ID Components:<ID number ID (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> PID-3- ID( ID) CK 2 3 Null null 0061 0061 M10 M11 Mod 10 Mod 11 128952^6^M11^ADT01 Mod10 =12345 531 2 1062 42 421062 6 15 15 10 20-15 5 Mod10 401 Mod10 0 9999 4 99999999 7 Mod11 d = 1 10 100 w = 1 10 100 W 2 3 4 5 6 7 2 3 4 5 6 7 (6 ) c = ( 1) m = 1 (d * w) d = 1 w = 1 6 2 7 ( 2) c1 = m mod 11 Copyright 1998 JAHIS V1.0 19
( 3) c1 =0 c1 =1 ( 4) c =(11 c1) mod 10 : if the number is 1234567, then the mod 11 check digit = 6 m =(7*2)+(6*3)+(5*4)+(4*5)+(3*6)+(2*7)+(1*2) = 14 + 18 + 20 + 20 + 18 + 14 + 2 = 106 c1 = 106 mod 11 = 7 c = (11-c1) mod 10 = 4 mod 10 = 4 CX ID Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD) )> ^ <identifier type code ID (IS)> ^ < assigning facility (HD) 1234567 4 M11 ADT01 MR University Hospital ID CK ST NM CK ST NM 0203 Value Value AM MA AN MC BR MR DI PI DL PN DN PT DS RR EI SS EN UPIN GI VS GN VN MS XX XCN ID Components:<ID numberid (ST)> ^ <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code (ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID )> ^ <identifier type code (IS)> ^ <assigning facility (HD)> 1 8 ID 2 7 PN 8 1 ID XPN 0203 : 12372^RIGGINS^JOHN^""^""^""^MD^ADT1 12372 ^RIGGINS^JOHN^""^""^""^MD Copyright 1998 JAHIS V1.0 20
1234567 Smith John J III DR PHD ADT01 L 4 M11 MR XAD Components:<street address (ST)> ^ <other designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code ZIP (ST)> ^ <country (ID)> ^ < address type (ID)> ^ <other geographic designation (ST)>^ <county/parish code / (IS)> ^ <census tract (IS)> 1234 Easy St. Ste. 123 San Francisco CA 95123 USA B SF Suite 555 4 HL7 0190 SMSA XPN Components: <family name (ST)> ^ <given name (ST)> ^ <middle initial or name ( ) (ST)> ^ <suffix (e.g., JR or III) ( JR) (ST)> ^ <prefix (e.g., DR) ( DR) (ST)> ^ <degree (e.g., MD) ( MD) (ST)> ^ <name type code (ID) > ^ <name representation code (ID)> HL7 0200 Smith^John^J^III^DR^PHD^L ^ ^^^^^D^I~ ^ ^^^^^D^P~ NIHON^Tarou^^^^^D^A Value A L D M C 0200 - Name type code (ID) Alias Name Legal Name Display Name Maiden Name Adopted Name 4000 - Name representation code (ID) Value I A P Ideographic (i.e., Kanji) ( ) Alphabetic (i.e., Default or some single-byte) Phonetic (i.e., ASCII, Katakana, Hiragana, etc) (ASCII, ) XON ID Components: <organization name (ST)> ^ <organization name type code (IS)> ^ <ID Number ID (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ <assigning authority (HD)> ^ <identifier type code (IS)> ^ <assigning facility ID ID (HD)> HL7 Health Center L 6 M11 HCFA 0204 Value A L D SL XTN Components:[NNN ] [(999 )]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use cod e (ID)> ^ <telecommunication equipment type Copyright 1998 JAHIS V1.0 21
(ID)> ^ <email address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)> (415) 555-3210 ORN FX Value PRN ORN WPN VHN ASN EMR NET BPN 0201 ( ) 0202 Value PH FX MD CP BP INTERNET NET X.400 X.400 NET 5 9 1 1 CD Components:<channel identifier (<channel number (NM)> & <channel name (ST)>) > ^ <electrode names (CM)> ^ <channel sensitivity/units (CM)> ^ <calibration parameters (CM)> ^ <sampling frequency (NM)> ^ <minimum/maximum data values (CM)> MA Components:<sample 1 from channel 1 (NM)> ^ <sample 1 from channel 2 (NM)> ^ <sample 1 from channel 3 (NM)>...~<sample 2 from channel 1 ( ) NA ( ) NM ED Components:<source application (HD) > ^ <data subtype (ID)> ^ <encoding (ID)> ^ <data (ST)> RP 0191 HL7 0291 ASCII HL7 0299 Value A Hex Base64 0299 ASCII 16 16 MIME( ) RFC1521 4 ASCII 3 Base64 ASCII 65 Copyright 1998 JAHIS V1.0 22
Value 0 9 + / = MIME RFC1521 Base64 24 (3 ) 6 64 HL7 0290 MIME base64 24 24 6 = (1) 24 = 4 (2) 8 2 = 2 (3) 16 1 = 3 0290 - MIME base64 Value/Code Value/Code Value/Code Value/Code 0 A 17 R 34 I 51 z 1 B 18 S 35 j 52 0 2 C 19 T 36 k 53 1 3 D 20 U 37 l 54 2 4 E 21 V 38 m 55 3 5 F 22 W 39 n 56 4 6 G 23 X 40 o 57 5 7 H 24 Y 41 p 58 6 8 I 25 Z 42 q 59 7 9 J 26 a 43 r 60 8 10 K 27 b 44 s 61 9 11 L 28 c 45 t 62 + 12 M 29 d 46 u 63 / 13 N 30 e 47 v 14 O 31 f 48 w (pad) = 15 P 32 g 49 x 16 Q 33 h 50 y ( 16 32 ) ASCII 2.8.14.2 PPN Components:<ID number (ST)> ^ <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code(id)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID )> ^ <identifier type code (IS)> ^ <assigning facility (HD)> ^ < date/time action performed (TS)> TS XCN TQ / Copyright 1998 JAHIS V1.0 23
5.5 QUANTITY/TIMING (TQ) DEFINITION / Components: <quantity (CQ)> ^ <interval (CM)> ^ <duration (ST)> ^ <start date/time (TS)> ^ <end date/time (TS)> ^ <priority (ST)> ^ <condition (ST)> ^ <text (TX)> ^ <conjunction (ST)> ^ <order sequencing (CM)> / (ORC-7,OBR-27) / / Quantity component (CQ) < & > 2 4 2 3 3 1 Interval component (CM) Subcomponents: < & > 1 2 Repeat pattern 4001 - Repeat pattern Q<integer>S every <integer> seconds Q<integer>M every <integer> minutes Q<integer>H every <integer> hours Q<integer>D every <integer> days Q<integer>W every <integer> weeks Q<integer>L every <integer> months (Lunar cycle) Q<integer>J<day#> J jour(day) < > 1 1= 7= Q2J2 2 Q1J6 BID 1 2 ( 9AM-4PM) TID 1 3 ( 9AM-4PM-9PM) QID 1 4 ( 9AM-11AM-4PM-9PM) xid 1 x X 5 ( 5ID= 5 8ID= 8 ) 4 Q< >H QID Q6H QAM QSHIFT 3 8 QOD (Q2D ) QHS QPM C U <spec> ) < > UNIX PRN PRNxxx xxx ( (PRNQ6H)) Once null Explicit time interval subcomponent 1 HHMM,HHMM,HHMM,... 2 1 ( / 4 ) Copyright 1998 JAHIS V1.0 24
/ hhmm HS xcy x A P I y M D V Ex: / 2...^QID&0230,0830,1430,2030^... 1 3 ^TID&PC Duration component INDEF( ) S<integer> = <integer> seconds M<integer> = <integer> minutes H<integer> = <integer> hours D<integer> = <integer> days W<integer> = <integer> weeks L<integer> = <integer> months X<integer> = 2 Q2H X3 2 3 2 6 T<integer> = < > DOSAGE INDEF = ( )- Start date/time component (TS) ( )-STAT) End date/time component (TS) Priority component (ID) ( R ) S = A = S R = P = C = T = PRN = As Needed T ( ) Format: TS<integer> = TM<integer> = TH<integer> = TD<integer> = TW<integer> = TL<integer> = Copyright 1998 JAHIS V1.0 25
Condition component (ST) PRN pain 110 ( ) Text component (TX) ( ) Conjunction component (ID) null 2 3 a) S = Synchronous (ORC 4 4 ORC 4 5 ) S 2 1 Q15 2 b) A = Asynchronous (ORC 4 4 ORC 4 5 ) A 2 1 1/2 c) C = This is an actuation time ( ) ( ORC 4 5 ORC 4 3 2 1 EKG (3) EKG 3 ^1^QAM^X3^D10 Order sequencing component (complex) (IV) ( 1 ) PRN pain ORC 4 / ORC 4 / 10 10 11 / 10 7 ( ) / 10 4 7 4-7. Subcomponent Contains Notes 1 / S ; C, R 2, 3 / : 2 Copyright 1998 JAHIS V1.0 26
Subcomponent Contains Notes HL7 4, 5 / : 2 HL7 6 : <one of "SS", "EE", "SE", or "ES"> +/- <time> 1 (S) (E) 1 2 3 4 2 (S) (E) / ( ). < > : S<integer> <integer> M<integer> <integer> H<integer> <integer> D<integer> <integer> W<integer> <integer> L<integer> <integer> 7 / 8,9 / : 2 : 2 ID(ST) ID (ID)( ) EI 2 HL7 10,11 / : 2 : 2 ID(ST) ID (ID)( ) EI 2 HL7 ORC 4 / 10 2 3 OE1000&OrdEnt ORC OE1001^OrdEnt ES + 10M SS - 10M OE1000&OrdEnt( ) 10 OE1001^OrdEnt( ) 10 10 10 ( ) Example: *FS+10M 10 1 1 / 4 IV 4 : 1 ORC 4 / 1 2 4 IV Copyright 1998 JAHIS V1.0 27
/ 4 ( ) 1 HL7 4 / / ( ) ( ) ( ) ( 10 ) Examples of quantity/timing usage / 3^once 3 1 1^QHS^X2 2 1 1^C^3D 3 1^Q1H^X4^^^^PVCs>10/min PVC 10 4 1 EKG 1^Q2J^^1432 2 32 1^^^^198911210800 11/21/89 0800 1^Q3600S^X5^198911051030 11/5/89 10:30 5 1 1^QAM^X3^^^^^^S~1^QOD^4D^^^^if K+>5.5. 3 5.5 4 ( 2 )1 ^^^198812120800^^T^^Trough specimen for MIC^C ~^^^^^R 12/12/1988 8:00 Copyright 1998 JAHIS V1.0 28
5.6 OBX NTE ID OBX OBX ( X ) ( ) HL7 ID ( 7 1 ) ID( OBR OBR 4 ID ID) X ID X ID(CPT4 71020) IMP ( 71020&IMP ) ID OBR OBX 3 &IMP &REC & 7-1. Observation ID suffices Coded Results Suffix Type Diagnostic Impression IMP CE Recommendation REC CE Confirming Procedures CNP CE Procedure Medication MED CE Anatomic Site ANT CE Device/Instrument / DEV CE Serial # Device/Instrument / SER ST Bulk Text Reports Gross Or General Of The Study GDT TX or FT Microscopic Or Secondary 2 MDT TX or FT Technician's Comment TCM TX or FT Addendum Note ADT TX or FT Other Diagnosis Onset Date/Time ITM TS Diagnosis Resolution Date/Time RTM TS Comparison Study CMS CE Comparison Date/Time CMT TS Comparison Results CMR CE Comparison Change CMC CE Predicted Value PRD ST Percent Predicted PPR ST After Drug Observed AFD ST Predicted Value After Drug ADP ST Percent Predicted After Drug APP ST Timing Information TIM TS Channel Definition Data CHN CD Waveform Digital Data WAS NA or MA Waveform Annotation ANO CE ID Diagnostic impressions (IMP) IMP CE OBX 1 Copyright 1998 JAHIS V1.0 29
CE 2 ( ) OBX Recommendations (REC) REC CE 6 ( ) REC Confirming procedure (CNP) OBX IMP OBX OBX 3 ID Procedure medication (MED) MED OBX 3 ( ) OBX OBX 3 1 ( ) OBX 5 2 Anatomic site (ANT) 1 ANT(OBX 3 ) OBX Devices (DEV) OBX 3 DEV CE 2 Serial# Device / Instrument / (SER) Gross or general description (GDT) EKG Copyright 1998 JAHIS V1.0 30
Secondary or microscopic description 2 (MDT) 2 OBX 3 MDT Technician comment (TCM) OBX 3 TCM Addendum note (ADT) Diagnosis (problem) onset date-time ( ) (ITM) Diagnosis (problem) resolution date-time ( ) (RTM) Comparison study (CMS) ( ID CMS OBX ) OBX ID Comparison date-time (CMT) Comparison results (CMR) ( ) Comparison change (CMC) ( ) Predicted (PRD) AS4 94010 1 94010 1&PRD Percent of predicted (PPR) ( )/( ) 94010 1&PPR After drug observed (AFD) ID AFD AS4 94010 1&AFD Predicted value after drug (ADP) ADP 94010 1&ADP Copyright 1998 JAHIS V1.0 31
Percent predicted after drug (APP) APP AS4 94010 1&APP Timing Information (TIM) TIM OBX ID 1 ID WAV TIM Channel Definition Data (CHN) CHN OBX 1 OBX-5 Waveform Digital Data (WAV) WAV OBX ( / (ADC) ) WAV (CHN OBX ) ID CHN WAV WAV ( OBX 65536 ) WAV ( ) WAV NA( ) MA( ) NA MA 1 ( ) 2 ( ) Waveform Annotation (ANO) ANO OBX ( ) ANO (CHN OBX ) ID CHN ANO ANO CE 0317 0317 - Annotations 9900 9901 SAS 9902 9903 9904 etc Copyright 1998 JAHIS V1.0 32
6. 6.1 MSH - message header segment MSH 2-8. MSH attributes SEQ LEN DT OPT RP/# ITEM # ELEMENT NAME 1 1 ST R 00001 Field Separator 2 4 ST R 00002 Encoding Characters 3 180 HD O 00003 Sending Application 4 180 HD O 00004 Sending Facility 5 180 HD O 00005 Receiving Application 6 180 HD O 00006 Receiving Facility 7 26 TS O 00007 Date/Time Of Message / 8 40 ST O 00008 Security 9 7 CM R 00009 Message Type 10 20 ST R 00010 Message Control ID 11 3 PT R 00011 Processing ID 12 8 ID R 00012 Version ID 13 15 NM O 00013 Sequence Number 14 180 ST O 00014 Continuation Pointer 15 2 ID O 00015 Accept Acknowledgment Type 16 2 ID O 00016 Application Acknowledgment Type 17 2 ID O 00017 Country Code 18 6 ID O Y/3 00692 Character Set 19 60 CE O 00693 Principal Language of Message 20 16 CE O Escape Sequence Optionality R - required O - optional C - conditional on the trigger event or on some other field(s) X - not used with this trigger event B - left in for backward compatibility with previous versions of HL7 Repetition N - no repetition Y - the field may repeat an indefinite or site determined number of times (integer)- the field may repeat up to the number of times specified in the integer MSH MSH-1 Field separator (ST) 00001 ID (MSH-2- ) MSH-2 Encoding characters (ST) 00002 4 ^~\& MSH-3 Sending application (HD) 00003 MSH-4 Sending facility (HD) 00004 MSH-5 Receiving application (HD) 00005 MSH-6 Receiving facility (HD) 00006 Copyright 1998 JAHIS V1.0 33
MSH-7 Date/time of message (TS) 00007 MSH-8 Security (ST) 00008 MSH-9 Message type (CM) 00009 Components: <message type (ID)> ^ <trigger event (ID)> 1 0076-2 0003-0076 - Message type ( ) Value ORM ORU Value O01 R01 W01 Order message Observ result/unsolicited 0003 Event type ( ) ORM - Order message ORU - Unsolicited transmission of an observation ORU - Waveform result, unsolicited transmission of requested information MSH-10 Message control ID ID (ST) 00010 MSH-11 Processing ID ID (PT) 00011 Components: <processing ID (ID)> ^<processing mode (ID)> Value D P T Value A R I not present 0103 - Processing ID ID Debugging Production Training 0207 - Processing mode Archive Restore from archive Initial load Not present (the default, meaning current processing) MSH-12 Version ID ID (ID) 00012 ID 2.3 Value 2.3 HL7 Release 2.3 1997 0104 - Version ID MSH-13 Sequence number (NM) 00013 1 MSH-14 Continuation pointer (ST) 00014 MSH-15 Accept acknowledgment type (ID) 00015 0155 Copyright 1998 JAHIS V1.0 34
MSH-16 Application acknowledgment type (ID) 00016 0155 0155 - Accept/application acknowledgment conditions Value AL NE ER SU Always Never Error/reject conditions only / Successful completion only MSH-15 MSH-16 ( null) MSH-17 Country code (ID) 00017 ISO 3166 MSH-18 Character set (ID) 00692 0211 Value ASCII 0211 - Alternate character sets The printable 7-bit ASCII character set. ( ) 8859/1 The printable characters from the ISO 8859/1 Character set 8859/2 The printable characters from the ISO 8859/2 Character set 8859/3 The printable characters from the ISO 8859/3 Character set 8859/4 The printable characters from the ISO 8859/4 Character set 8859/5 The printable characters from the ISO 8859/5 Character set 8859/6 The printable characters from the ISO 8859/6 Character set 8859/7 The printable characters from the ISO 8859/7 Character set 8859/8 The printable characters from the ISO 8859/8 Character set 8859/9 The printable characters from the ISO 8859/9 Character set JAS2020 JIS X 0202 JIS X 0201-1976 JIS X 0208-1997 JIS X 0212-1990 A subset of ISO2020 used for most Kanji transmissions ISO 2022 with escape sequences for Kanji Code for Information Exchange Code for the Japanese Graphic Character set for information interchange Code of the supplementary Japanese Graphic Character set for information interchange : 7-bit ASCII PN XPN Null single-byte character set (ASCII (ISO IR-6)) ( ISO-IR 6, ISO-IR 13, ISO-IR 14, ISO-IR 100, etc.) ( JIS X 0208) ISO-IR 6 (ISO 646) or ISO-IR 14 (JIS X 0201-1976) G0 ~JIS X0208-1997 JIS ~JIS X0212-1990 MSH-19 Principal language of message (CE) 00693 ISO 639 MSH-20 Escape sequence (CE) 211 JIS X0202 ISO 2022 Copyright 1998 JAHIS V1.0 35
6.2 NTE - notes and comments segment NTE NTE 2-22. NTE attributes SEQ LEN DT OPT RP/# ITEM # ELEMENT NAME 1 4 SI O 00096 Set ID - NTE ID-NTE 2 8 ID O 00097 Source of Comment 3 64k FT O Y 00098 Comment NTE NTE-1 Set ID - NTE ID-NTE (SI) 00096 : NTE NTE-2 Source of comment (ID) 00097 : 0105 Value L P O Ancillary (filler) department is source of comment Orderer (placer) is source of comment Other system is source of comment NTE-3 Comment (FT) 00098 : Copyright 1998 JAHIS V1.0 36
6.3 PID - patient identification segment PID 3-2. PID attributes PID SEQ LEN DT OPT RP/# ITEM# ELEMENT NAME 1 4 SI 00104 Set ID - Patient ID ID 2 16 CK 00105 Patient ID (External ID) ID( ID) 3 20 CX R Y 00106 Patient ID (Internal ID) ID( ID) 4 12 ST Y 00107 Alternate Patient ID - PID ID 5 48*n XPN R Y 00108 Patient Name 6 48 XPN 00109 Mother's Maiden Name 7 26 TS 00110 Date/Time of Birth 8 1 IS 00111 Sex 9 48 XPN Y 00112 Patient Alias 10 1 IS 00113 Race 11 106 XAD Y 00114 Patient Address 12 4 IS 00115 County Code 13 40 XTN Y 00116 Phone Number - Home 14 40 XTN Y 00117 Phone Number - Business 15 60 CE 00118 Primary Language 16 1 IS 00119 Marital Status 17 3 IS 00120 Religion 18 20 CX 00121 Patient Account Number 19 16 ST 00122 SSN Number - Patient SSN 20 25 CM 00123 Driver's Lic Num - Patient 21 20 CX 00124 Mother's Identifier 22 3 IS 00125 Ethnic Group 23 60 ST 00126 Birth Place 24 2 ID 00127 Multiple Birth Indicator 25 2 NM 00128 Birth Order 26 4 IS Y 00129 Citizenship 27 60 CE 00130 Veterans Military Status 28 80 CE 00739 Nationality 29 26 TS 00740 Patient Death Date and Time 30 1 ID 00741 Patient Death Indicator PID PID-1 Set ID - patient ID ID (SI) 00104 ID ID 1 2 3 PID PID-2 Patient ID (external ID) ID( ID) (CK) 00105 ID ID PID-3 Patient ID (internal ID ID( ID) (CX) 00106 ID( ID ) ORM ID PID-4 Alternate patient ID - PID ID (ST) 00107 3 ID ID ID PID-5 Patient name (XPN) 00108 : <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix Copyright 1998 JAHIS V1.0 37
(e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <name type code (ID) > ^ <name representation code (ID)> Value A L D M C Value I A P 0200 - Name type Alias Name Legal Name Display Name Maiden Name ( ) Adopted Name 4000 name representation code Ideographic (i.e., Kanji) Alphabetic (i.e., Default or some single-byte) Phonetic (i.e., ASCII, Katakana, Hiragana, etc.) (ASCII, ) MSH-18 ASCII~JIS X0208-1997 PID-5 Yamada^Tarou^^^^L^A~ ^ ^^^^L^I~ ^ ^^^^L^P L PID-6 Mother's maiden name (XPN) 00109 M PID-7 Date/Time of birth (TS) 00110 nnnu Y L W D Y (YYYYLLDDHHMMSS^nnnu) 19900301^7 1990 3 1 7 ^10 10 ^5D 5 PID-8 Sex (IS) 00111 0001 0001 Value F M O U PID-9 Patient alias (XPN) 00112 Female Male Other Unknown PID-10 Race (IS) 00113 PID-11 Patient address (XAD) 00114 PID-12 County code (IS) 00115 PID-13 Phone number - home (XTN) 00116 PID-14 Phone number - business (XTN) 00117 PID-15 Primary language (CE) 00118 Copyright 1998 JAHIS V1.0 38
PID-16 Marital status (IS) 00119 0002 - Marital status Value A D M S W Separated Divorced Married Single Widowed PID-17 Religion (IS) 00120 PID-18 Patient account number (CX) 00121 PID-19 SSN number - patient SSN (ST) 00122 PID-20 Driver's license number - patient (CM) 00123 2 PID-21 Mother's identifier (CX) 00124 ID PID-22 Ethnic group (IS) 00125 PID-23 Birth place (ST) 00126 PID-24 Multiple birth indicator (ID) 00127 Y/N PID-25 Birth order (NM) 00128 PID-26 Citizenship (IS) 00129 0171 ISO3166 PID-27 Veterans military status (CE) 00130 PID-28 Nationality (CE) 00739 PID-29 Patient death date and time (TS) 00740 PID-30 Patient death indicator (ID) 00741 Y/N Copyright 1998 JAHIS V1.0 39
6.4 PV1 - patient visit segment PV1 /ADT 3-3. PV1 attributes SEQ LEN DT OPT RP/# ITEM# ELEMENT NAME 1 4 SI O 00131 Set ID - Patient Visit ID 2 1 IS R 00132 Patient Class 3 12 PL O 00133 Assigned Patient Location 4 2 IS O 00134 Admission Type 5 20 CX O 00135 Preadmit Number 6 12 PL O 00136 Prior Patient Location 7 60 XCN O Y 00137 Attending Doctor 8 60 XCN O Y 00138 Referring Doctor 9 60 XCN O Y 00139 Consulting Doctor 10 3 IS O 00140 Hospital Service 11 12 PL O 00141 Temporary Location 12 2 IS O 00142 Preadmit Test Indicator 13 2 IS O 00143 Readmission Indicator 14 3 IS O 00144 Admit Source 15 2 IS O Y 00145 Ambulatory Status 16 2 IS O 00146 VIP Indicator VIP 17 60 XCN O Y 00147 Admitting Doctor 18 2 IS O 00148 Patient Type 19 15 CK O 00149 Visit Number 20 50 CM O Y 00150 Financial Class 21 2 IS O 00151 Charge Price Indicator 22 2 IS O 00152 Courtesy Code 23 2 IS O 00153 Credit Rating 24 2 IS O Y 00154 Contract Code 25 8 DT O Y 00155 Contract Effective Date 26 12 NM O Y 00156 Contract Amount 27 3 NM O Y 00157 Contract Period 28 2 IS O 00158 Interest Code 29 1 IS O 00159 Transfer to Bad Debt Code 30 8 DT O 00160 Transfer to Bad Debt Date 31 10 IS O 00161 Bad Debt Agency Code 32 12 NM O 00162 Bad Debt Transfer Amount 33 12 NM O 00163 Bad Debt Recovery Amoun t 34 1 IS O 00164 Delete Account Indicator 35 8 DT O 00165 Delete Account Date 36 3 IS O 00166 Discharge Disposition 37 25 IS O 00167 Discharged to Location 38 2 IS O 00168 Diet Type 39 2 IS O 00169 Servicing Facility 40 1 IS O 00170 Bed Status 41 2 IS O 00171 Account Status 42 12 PL O 00172 Pending Location 43 12 PL O 00173 Prior Temporary Location 44 26 TS O 00174 Admit Date/Time / 45 26 TS O 00175 Discharge Date/Time / 46 12 NM O 00176 Current Patient Balance 47 12 NM O 00177 Total Charges 48 12 NM O 00178 Total Adjustments 49 12 NM O 00179 Total Payments 50 20 CX O 00180 Alternate Visit ID ID 51 1 IS O 01226 Visit Indicator 52 60 XCN O Y 01224 Other Healthcare Provider PV1 Copyright 1998 JAHIS V1.0 40
PV1-1 Set ID - patient visit ID (SI) 00131 PV1-2 Patient class (IS) 00132 0004 - Patient class Value E I O P R B C Emergency Inpatient Outpatient Preadmit Recurring Patient Obstetrics Checkup PV1-3 Assigned patient location (PL) 00133 : <point of care (IS )> ^ <room (IS )> ^ <bed (IS )> ^ <facility (HD)> ^ < location status (IS )> ^ <person location type (IS)> ^ <building (IS )> ^ <floor (IS )> ^ <location description (ST)> PL 5 ( ) PV1-40 0116 - Bed status Value C H O U K I Closed Housekeeping Occupied Unoccupied Contaminated Isolated PV1-4 Admission type (IS) 00134 0007 - Admission type Value A E L R Accident Emergency Labor and Delivery Routine PV1-5 Pre-admit number (CX) 00135 PV1-6 Prior patient location (PL) 00136 NULL PV1-7 Attending doctor (XCN) 00137 ID PV1-8 Referring doctor (XCN) 00138 ID PV1-9 Consulting doctor (XCN) 00139 Copyright 1998 JAHIS V1.0 41
PV1-10 Hospital service (IS) 00140 A01,A02,A14,A15 PV1-11 Temporary location (PL) 00141 ( OR). PV1-12 Pre-admit test indicator (IS) 00142 PV1-13 Re-admission indicator (IS) 00143 R Null PV1-14 Admit source (IS) 00144 PV1-15 Ambulatory status (IS) 00145 0009- Value A0 A1 A2 A3 A4 A5 A6 A7 A8 A9 B1 B2 B3 B4 B5 B6 0009 - Ambulatory status No functional limitations Ambulates with assistive device Wheelchair/stretcher bound / Comatose; non-responsive Disoriented Vision impaired Hearing impaired Speech impaired Non-English speaking Functional level unknown Oxygen Therapy Special equipment (tubes, IVs, catheters) ( IV ) Amputee Mastectomy Paraplegic Pregnant PV1-16 VIP indicator VIP (IS) 00146 VIP PV1-17 Admitting doctor (XCN) 00147 ID PV1-18 Patient type (IS) 00148 PV1-19 Visit number (CK) 00149 PV1-20 Financial class (CM) 00150 PV1-21 Charge price indicator (IS) 00151 PV1-22 Courtesy code (IS) 00152 PV1-23 Credit rating (IS) 00153 PV1-24 Contract code (IS) 00154 Copyright 1998 JAHIS V1.0 42
PV1-25 Contract effective date (DT) 00155 PV1-26 Contract amount (NM) 00156 PV1-27 Contract period (NM) 00157 PV1-28 Interest code (IS) 00158 PV1-29 Transfer to bad debt code (IS) 00159 PV1-30 Transfer to bad debt date (DT) 00160 PV1-31 Bad debt agency code (IS) 00161 PV1-32 Bad debt transfer amount (NM) 00162 PV1-33 Bad debt recovery amount (NM) 00163 PV1-34 Delete account indicator (IS) 00164 PV1-35 Delete account date (DT) 00165 PV1-36 Discharge disposition (IS) 00166 ( ) PV1-37 Discharged to location (IS) 00167 PV1-38 Diet type (IS) 00168 PV1-39 Servicing facility (IS) 00169 PV1-40 Bed status (IS) 00170 PL 5 PV1-41 Account status (IS) 00171 PV1-42 Pending location (PL) 00172 ID 5 ( ) PV1-40 PV1-43 Prior temporary location (PL) 00173 PV1-44 Admit date/time (TS) 00174 / PV1-45 Discharge date/time (TS) 00175 / Copyright 1998 JAHIS V1.0 43
PV1-46 Current patient balance (NM) 00176 PV1-47 Total charges (NM) 00177 PV1-48 Total adjustments (NM) 00178 PV1-49 Total payments (NM) 00179 PV1-50 Alternate visit ID ID (CX) 00180 ID ID PV1-51 Visit indicator (IS) 01226 0326 - Visit Indicator Value A no value Account Level Visit Level PV1-52 Other healthcare provider (XCN) 01224 ( ) Copyright 1998 JAHIS V1.0 44
6.5 AL1 - patient allergy information segment AL1 AL1 3-6. AL1 attributes SEQ LEN DT OPT RP/# ITEM# ELEMENT NAME 1 4 SI R 00203 Set ID - Allergy ID 2 2 IS 00204 Allergy Type 3 60 CE R 00205 Allergy Code/Mnemonic/ / 4 2 IS 00206 Allergy Severity 5 15 ST 00207 Allergy Reaction 6 8 DT 00208 Identification Date AL1 AL1-1 Set ID - allergy ID (SI) 00203 ID AL1-2 Allergy type (IS) 00204 ( ) 127 Value DA FA MA MC 0127 - Allergy type Drug Allergy Food Allergy Miscellaneous Allergy Miscellaneous Contraindication AL1-3 Allergy code/mnemonic/description / (CE) 00205 ( ) AL1-4 Allergy severity (IS) 00206 ( ) 128 0128 - Allergy severity Value SV MO MI Severe Moderate Mild AL1-5 Allergy reaction (ST) 00207 ( ) AL1-6 Identification date (DT) 00208 Copyright 1998 JAHIS V1.0 45
6.6 ORC - common order segment (ORC) ( ) ORC ORC OK < > < > <CR> ORC (HD ORC-1 ORC-2 ORC-3 ) ORC ORC a) 1 1 ORC-4- (ORCs) ORCs b) ORC ( ) ORC ( OBR RXO) ORC-2 OBR-2 ASTM ORC c) / 1)EKG 3 EKG 3 2)EKG 3 EKG 1 3) 1 EKG ( ) 4) 4-1. ORC attributes ORC SEQ LEN DT OPT RP/# ITEM# ELEMENT NAME 1 2 ID R 00215 Order Control 2 22 EI C 00216 Placer Order Number 3 22 EI C 00217 Filler Order Number 4 22 EI O 00218 Placer Group Number 5 2 ID O 00219 Order Status 6 1 ID O 00220 Response Flag 7 200 TQ O 00221 Quantity/Timing / 8 200 CM O 00222 Parent 9 26 TS O 00223 Date/Time of Transaction 10 120 XCN O 00224 Entered By 11 120 XCN O 00225 Verified By 12 120 XCN O 00226 Ordering Provider 13 80 PL O 00227 Enterer's Location 14 40 XTN O Y/2 00228 Call Back Phone Number 15 26 TS O 00229 Order Effective Date/Time 16 200 CE O 00230 Order Control Code Reason 17 60 CE O 00231 Entering Organization 18 60 CE O 00232 Entering Device 19 120 XCN O 00233 Action By Copyright 1998 JAHIS V1.0 46
ORC ORC-1 Order control (ID) 00215 0119-3 a) NW ( ) CA ( ) b) OK ( ) CR ( ) c) OC ( ) OD ( ) ( CR) ( CA) 0119 Value 1 Originator 2 Field Note 3 NW New order P I OK Order accepted & OK & OK F I UA Unable to Accept Order F n CA Cancel order request P a OC Order canceled F CR Canceled as requested ( ) F UC Unable to cancel ( ) F b DC Discontinue order request P c OD Order discontinued F DR Discontinued as requested ( ) F UD Unable to discontinue ( ) F HD Hold order request P OH Order held F UH Unable to put on hold ( ) F HR On hold as requested ( ) F RL Release previous hold P OE Order released F OR Released as requested ( ) F UR Unable to release ( ) F RP Order replace request P e,d,h RU Replaced unsolicited ( ) F f,d,h RO Replacement order P,F g,d,h,l RQ Replaced as requested F d,e,g,h UM Unable to replace ( ) F PA Parent order F I CH Child order F,P i XO Change order request P XX Order changed, unsol. ( ) F Copyright 1998 JAHIS V1.0 47
Value 1 Originator 2 Field Note 3 UX Unable to change ( ) F XR Changed as requested ( ) F DE Data errors P,F RE Observations to follow P,F j RR Request received P,F k SR Response to send order status request F SS Send order status request P SC Status changed F,P SN Send order number F l NA Number assigned P l CN Combined result F m RF Refill order request F, P o AF Order refill request approval P p DF Order refill request denied P q FU Order refilled, unsolicited F r OF Order refilled as requested F s UF Unable to refill F t ORC a) CA CR (ORC-1- ) b) UC UC ( ) ORC-6- c) DC d) RP, RQ, RU, RO 1 / RP( ) ORC-1- RU( )) RU ORC (RP RU ) ORC (RP RU ) RO( ) ORC-1- ORC RO ORC 2 OBR 3 4-2. RU and RO usage (example) Segment Order Control Comment Copyright 1998 JAHIS V1.0 48
Segment Order Control Comment ORC RU 1st replaced ORC OBR 1st replaced order's detail segment ORC RU 2nd replaced ORC OBR 2nd replaced order's detail segment ORC RO 1st replacement ORC OBR 1st replacement order's detail segment ORC RO 2nd replacement ORC OBR 2nd replacement order's detail segment ORC RO 3rd replacement ORC OBR 3rd replacement order's detail segment ORC-6- OBR 1 1 1 1 2 RP 2 RU( )) 2 RQ( ) 4-3. RQ and RO usage (example) Segment Order Control Comment ORC RQ 1st replaced ORC OBR 1st replaced order's detail segment ORC RQ 2nd replaced ORC OBR 2nd replaced order's detail segment ORC RO 1st replacement ORC OBR 1st replacement order's detail segment ORC RO 2nd replacement ORC OBR 2nd replacement order's detail segment ORC RO 3rd replacement ORC OBR 3rd replacement order's detail segment e) RP, RQ 1 1 f) RU ( ) g) RO, RQ RP RU h) RP, RQ, RU, RO RO ORC (RP RU) RU ( ) RU ORC RP ( ) ORU ( ) 1) RO ORC 2) OBR ( ) Copyright 1998 JAHIS V1.0 49
3) (OBX) 4) NTE ORU OBR( ) OBX i) PA, CH (PA) (CH) ( ) PA ORC-1-1 ORC CH ORC-1-1 ORC ORC-6- OBR 2 4-4. Example of two child orders Segment Order Control Comment ORC PA 1st parent ORC ORC CH 1st child ORC OBR 1st child order ORC CH 2nd child ORC OBR 2nd child order SN/NA 2 SN/NA ORC ORC-8- ( ) ( ) 3 EKG j) RE ( OBR) 1 (OBX) ORU 3 RE 4-5. RE usage (example) Segment Order Control Comment MSH PID ORC NW First new order RXO First order segment ORC NW 2nd new order RXO 2nd order segment [ORC RE Patient-specific observation, optional in V 2.2 OBR] Observation OBR, optional in V 2.2 OBX An observation segment OBX Another observation segment OBX Another observation segment OBX Another observation segment ORC NW 3rd order RXO 3rd order segment HL7 1 OBX Copyright 1998 JAHIS V1.0 50
ORC OBR ORC ORU ORU OBR ORC ORU RE ORM (OBX) RE ORU OBR (OBX) k) RR l) SN, NA, NW 3 (ORC-2-3- ) 1) HIS ORC-3-2) ORC- 2-3) ( ) ORC-3-1) SN ORC-3- HIS ( ) HIS SN ORC-1- ORM ORC Null ORC-3- ORC-2- ORM(SN ) 2 i) OK ORC-1- ORR ORM NA ORC-1- ORC ii) NA ORC-l- ORR NA ORC-1- NA ORC-2- (SN ORC ) ID. Code From ORC-2-Placer Order Number ORC-3-Filler Order Number SN filler application placer order number^filler application ID null NA other application placer order number^filler application ID filler order number^filler application ID 2) SN ORC-2- SN ORC-1- ORM ORC null ORC-2- ORC-3- ORM(SN ) 2 i) OK ORC-1- ORR ORM NA ORC-1- ORC Copyright 1998 JAHIS V1.0 51
ii) NA ORC-l- ORR NA ORC-2- ORC NA ORC-1- ORC-2- ORC-3- (SN ORC ) Code From ORC-2-Placer Order Number ORC-3-Filler Order Number SN filler application null filler order number^filler application ID NA other application placer order number^placer application ID filler order number^filler application ID 3) NW ( ) RO (RO following an RP). ORC3-2 ID Code From ORC-2-Placer Order Number ORC-3-Filler Order Number NW, RO other application to the filler placer order number^placer application ID filler order number^filler application ID m) CN CN ORC RE ORC OBR 3 ORC MSH... PID... ORC CN... OBR A4461XA^HIS 81641^RAD 73666^Bilateral Feet... ORC CN... OBR A4461XB^HIS 81642^RAD 73642^Bilateral Hand PA... ORC RE... OBR A4461XC^HIS 81643^RAD 73916^Bilateral Knees... OBX CE 73916&IMP Radiologist's Impression... OBX CE 73642&IMP Radiologist's Impression... OBX FT 73642&GDT... n) UA MSA. o) RF RF p) AF AF q) DF DF NCPDF SCRIPT Copyright 1998 JAHIS V1.0 52
AA AB AC AD AE AF AG Patient unknown to the provider Patient never under provider care Patient no longer under provider care Patient has requested refill too soon Medication never prescribed for the patient Patient should contact provider first Refill not appropriate FU OF UF r) FU. s) OF t) UF ORC-2 Placer order number ( EI) 00216 1 ( (OBR)) 15 ( ) 2 ID 6 ID 2 3 a) RU RO ORC-1- b) CH( ) ORC-1- c) SN( ) ORC-1- ORC-2- ORC-1- ID 1 ( ) ORM ORR ID (MSH ) ORC-2- OBR-2- ORC OBR ORC-2- OBR-2- ORU ORC OBR ORC OBR ( / ) ORC-3 Filler order number ( EI) 00217 1 15 ( OBR) ( ( ) ( ) 2 ID 6 Copyright 1998 JAHIS V1.0 53
2 ID 1 ( ) ORM ORR ID (MSH ) ORC-3- OBR-2- ORC OBR ( ORC OBR ASTM ) ORU ORC OBR (OBR-3 ORC-3) ( ) ORM CA ORC-1 ORC ORC-4 Placer group number (EI) 00218 1 15 ORC 2 ID ORC-2-2 ORC-5 Order status (ID) (ID) 00219 0038 0038 0119 ORC-1- SR SC Value A CA CM DC ER HD IP 0038 - Order status Some, but not all, results available Order was canceled Order is completed Order was discontinued Error, order not found Order is on hold In process, unspecified Copyright 1998 JAHIS V1.0 54
Value RP SC Order has been replaced In process, scheduled ORC-6 Response flag (ID) 00220 ( ) ( ) null D 0121- Value E R D F N 0121 - Response flag Report exceptions only Same as E, also Replacement and Parent-Child E Same as R, also other associated segments R Same as D, plus confirmations explicitly D Only the MSA segment is returned MSA ORC-7 Quantity/timing / (TQ) 00221 4.4 OBR ORC-7- / 1-XQAM X3 ORC-7- / OBR-27- / ORC-8 Parent (CM) 00222 Components: <parent's placer order number (EI)> ^ <parent's filler order number (EI)> Subomponents of parent s placer order number: <entity identifier (ST)> & <application identifier 1(IS)> & <universal identifier (UI)> Subomponents of parent s filler order number: <entity identifier (ST)> & <application identifier 1(IS)> & <universal identifier (UI)> ORC-1-1 2 2 ORC-8- OBR-29- ORC-9 Date/time of transaction (TS) 00223 ORC-10- ORC-11- ORC-13- ORC-10 Entered by (XCN) 00224 ID ORC-11 Verified by (XCN) 00225 ID Copyright 1998 JAHIS V1.0 55
ORC-12 Ordering provider (XCN) 00226 ORC-12- OBR-16- ORC-13 Enterer's location (PL) 00227 ( ) ICU4 4 ICU ORC-14 Call back phone number (XTN) 00228 ORC-14- OBR-17- ORC-15 Order effective date/time (TS) 00229 ORC-9- ( ) ORC-15- ORC-16- ORC ORC-9- ORC-15- ORC ORC-15- ORC-9- MSH-7- ORC-15- ( ORC ) ORC-7- / ORC-15- ORC ORC-7- / ORC ORC-16 Order control code reason (CE) 00230 ( 0119) ( RXO ORO OBR) NTE ORC-1- NW ORC-16- ( ) ORC-17 Entering organization (CE) 00231 / ORC-18 Entering device (CE) 00232 ( PC) ORC-19 Action by (XCN) 00233 CA( ) Copyright 1998 JAHIS V1.0 56
6.7 OBR - observation request segment (ASTM 1238 91 ) (OBR) ( EKG) ( ) 1 1 ( X ) ( CBC ) ( ) X( ) OBR 25 (OBR) (OBX) OBX 4 8 OBR ( ) OBR ( ) ( ) OBR 7 / OBR 8 / ( ) 2 (BP X ) 4-8. OBR attributes OBR SEQ LEN DT OPT RP/# ITEM # ELEMENT NAME 1 4 SI C 00237 Set ID - Observation Request ID 2 75 EI C 00216 Placer Order Number 3 75 EI C 00217 Filler Order Number + 4 200 CE R 00238 Universal Service ID ID 5 2 ID B 00239 Priority 6 26 TS B 00240 Requested Date/time 7 26 TS C 00241 Observation Date/Time # / 8 26 TS O 00242 Observation End Date/Time # / 9 20 CQ O 00243 Collection Volume * 10 60 XCN O Y 00244 Collector Identifier * 11 1 ID O 00245 Specimen Action Code * 12 60 CE O 00246 Danger Code ( ) 13 300 ST O 00247 Relevant Clinical Info. 14 26 TS C 00248 Specimen Received Date/Time * 15 300 CM O 00249 Specimen Source * 16 80 XCN O Y 00226 Ordering Provider Copyright 1998 JAHIS V1.0 57
17 40 XTN O Y/2 00250 Order Callback Phone Number 18 60 ST O 00251 Placer field 1 1 19 60 ST O 00252 Placer field 2 2 20 60 ST O 00253 Filler Field 1 + 1 21 60 ST O 00254 Filler Field 2 + 2 22 26 TS C 00255 Results Rpt/Status Chng Date/Time + / - 23 40 CM O 00256 Charge to Practice + 24 10 ID O 00257 Diagnostic Serv Sect ID ID 25 1 ID C 00258 Result Status + 26 200 CM O 00259 Parent Result + 27 200 TQ O Y 00221 Quantity/Timing / 28 150 XCN O Y/5 00260 Result Copies To 29 150 CM O 00261 Parent Number * 30 20 ID O 00262 Transportation Mode 31 300 CE O Y 00263 Reason for Study 32 200 CM O 00264 Principal Result Interpreter + 33 200 CM O Y 00265 Assistant Result Interpreter + 34 200 CM O Y 00266 Technician + 35 200 CM O Y 00267 Transcriptionist + 36 26 TS O 00268 Scheduled Date/Time + 37 4 NM O 01028 Number of Sample Containers * 38 60 CE O Y 01029 Transport Logistics of Collected Sample * 39 200 CE O Y 01030 Collector's Comment * 40 60 CE O 01031 Transport Arrangement Responsibility 41 30 ID O 01032 Transport Arranged 42 1 ID O 01033 Escort Required 43 200 CE O Y 01034 Planned Patient Transport Comment OBR OBR-1 Set ID - observation request ID-OBR (SI) 00237 1 2 2 3 OBR-2 Placer order number ( EI) 00216 ORC 2 1 15 OBR ( ) ID 6 OBR-3 Filler order number ( EI) 00217 1 OBR ( ) ( ) 2 ID OBR 3 ORC 3 OBR-4 Universal service ID ID (CE) 00238 / / OBX L C123^ ^L OBR-5 Priority (ID) 00239 OBR 27 / 6 Copyright 1998 JAHIS V1.0 58
OBR-6 Requested date/time (TS) 00240 OBR-7 Observation date/time / (TS) 00241 OBR-8 Observation end date/time / (TS) 00242 null OBR-9 Collection volume (CQ) 00243 ML ISO (ISO 2955 1977 ) 24 1 24 OBR-7,OBR-8 OBR-9 OBR-9 1 OBR-10 Collector identifier ID (XCN) 00244 ID ( ) OBR-11 Specimen action code (ID) 00245 ORC (ORC NW ) ( L O ) 0065 Value A G L O P R S B D K C F U T N 0065 - Specimen action code Add ordered tests to the existing specimen Generated order; reflex order Lab to obtain specimen from patient Specimen obtained by service other than Lab Pending specimen; Order sent prior to delivery Revised order Schedule the tests specified below OBR-12 Danger code ( ) (CE) 00535 ( ) Copyright 1998 JAHIS V1.0 59
OBR-13 Relevant clinical information (ST) 00247 OBX ( ) OBX OBR-14 Specimen received date/time (TS) 00248 / OBR-15 Specimen source ( ) (CM) 00249 :< (CE)> < (TX)> < (CE)> < (CE)> < (5.2 ) 1 (CE ) ( ) 2 EDTA( ) 3 OBX 4 5 (anticubital fossa) CE 6 F- R- - OBR-16 Ordering provider (XCN) 00226 ID ID ORC 12 OBR-17 Order callback phone number (XTN) 00250 ( ) OBR-18 Placer field #1 1 (ST) 00251 1 OBR-19 Placer field #2 2 (ST) 00252 1 OBR-20 Filler field #1 1 (ST) 00253 ( ) OBR-21 Filler field #2 2 (ST) 00254 1 OBR-22 Results rpt/status chng - date/time / (TS) 00255 ( ) ( ) OBR-23 Charge to practice (CM) 00256 1 ( ) 2 ( Copyright 1998 JAHIS V1.0 60
) ( ) OBR-24 Diagnostic serv sect ID ID (ID) 00257 ID 0074 ID 0074 - Diagnostic service section ID Value Value AU Audiology OUS OB Ultrasound BG Blood gases OT Occupational Therapy BLB Blood bank OTH Other CUS Cardiac Ultrasound OSL Outside Lab CTH Cardiac catheterization PHR Pharmacy CT CAT scan PT Physical Therapy CH Chemistry PHY Physician (Hx. Dx, admission note, etc.l) CP Cytopathology PF Pulmonary function EC Electrocardiac (e.g., EKG, EEC, Holter) RAD Radiology EN Electroneuro (EEG, EMG,EP,PSG) RX Radiograph HM Hematology RUS Radiology ultrasound ICU Bedside ICU Monitoring RC Respiratory Care (therapy) IMM Immunology RT Radiation therapy LAB Laboratory SR Serology MB Microbiology SP Surgidal Pathology MCB Mycobacteriology TX Toxicology MYC Mycology VUS Vascular Ultrasound NMS Nuclear medicine scan VR Virology NMR Nuclear magnetic resonance XRC Cineradiograph NRS Nursing service measures OBR-25 Result status (ID) 00258 OBX OBX 11 0123 0123 - Result status Value O Order received; specimen not yet received I No results available; specimen received, procedure incomplete S No results available; procedure scheduled, but not done A Some, but not all, results available P Preliminary: A verified early result is available, final results not yet obtained C Correction to results R Results stored; not yet verified F Final results; results stored and verified. Can only be changed with a corrected result. X No results available; Order canceled. Y No order on record for this test. (Used only on queries) ( ) Z No record of this patient. (Used only on queries) ( ) OBR-26 Parent result (CM) 00259 : <OBX-3-observation identifier of parent result> ^ <OBX-4-sub-ID of parent result> ^ <OBX- 5-observation results from parent (CE)> ( ) OBR-29- OBX OBX 3 Copyright 1998 JAHIS V1.0 61
OBR-29- (OBX) OBX 4 ID ID N OBX N ID OBX OBR-27 Quantity/timing / (TQ) 00221 1 / OBR-28 Result copies to (XCN) 00260 ID OBR-29 Parent number (CM) 00261 ORC 8 ( ) ( ) 2 1 2 2 OBR-30 Transportation mode (ID) 00262 ( ) 0124 Value CART PORT WALK WHLC 0124 - Transportation mode Cart - patient travels on cart or gurney The examining device goes to patient's location Patient walks to diagnostic service Wheelchair OBR-31 Reason for study (CE) 00263 OBR-32 Principal result interpreter ( CM) 00264 ID OBR-33 Assistant result interpreter ( CM) 00265 OBR-34 Technician ( CM) 00266 OBR-35 Transcriptionist ( CM) 00267 OBR-36 Scheduled - date/time (TS) 00268 ( ) OBR-37 Number of sample containers (NM) 01028 OBR-38 Transport logistics of collected sample (CE) 01029 Copyright 1998 JAHIS V1.0 62
OBR-39 Collector's comment (CE) 01030 OBR-40 Transport arrangement responsibility (CE) 01031 OBR-41 Transport arranged (ID) 01032 Value A N U 0224 - Transport arranged Arranged Not Arranged Unknown OBR-42 Escort required (ID) 01033 OBR-43 Value R N U 0225 - Escort required Required Not Required Unknown OBR-43 Planned patient transport comment (CE) 01034 Copyright 1998 JAHIS V1.0 63
6.8 OBX - observation/result segment OBX 7 9 OBX OBX OBX OBX OBR OBX OBR GOT,GPT,HBs OBR 100g OBX, 30 7-9. OBX attributes OBX SEQ LEN DT OPT RP/# ITEM# ELEMENT NAME 1 10 SI O 00569 Set ID - Observational Simple ID 2 2 ID R 00570 Value Type 3 590 CE R 00571 Observation Identifier 4 20 ST C 00572 Observation Sub-ID ID 5 65536 * C Y 00573 Observation Value 6 60 CE O 00574 Units 7 10 ST O 00575 References Range 8 5 ID O Y/5 00576 Abnormal Flags 9 5 NM O 00577 Probability 10 2 ID O Y 00578 Nature of Abnormal Test 11 1 ID R 00579 Observ Result Status 12 20 TS O 00580 Date Last Obs Normal Values 13 26 ST O 00581 User Defined Access Checks 14 200 TS O 00582 Date/Time of the Observation 15 60 CE O 00583 Producer's ID ID 16 80 XCN O 00584 Responsible Observer 17 60 CE O Y 00936 Observation Method 18 1 CE O Template indicator OBX OBX-1 Set ID - observation simple ID- (SI) 00569 ASTM OBX-2 Value type (ID) 00570 : OBX CE TX FT 0125- (5.4 ) PN 6 NM ( >300 ) (ST) ">300" ">" "300" HL7 CM: CQ: OBX-5- OBX-6- SI ID: HL7 OBX RP ( ) ( ) OBX ACR-NEMA Copyright 1998 JAHIS V1.0 64
Value AD CE CF CK CN CP CX DT ED FT MO NM PN RP SN ST TM TN TS TX XAD XCN XON XPN XTN 0125 - Value type Address Coded Entry Coded Element With Formatted Values Composite ID With Check Digit Composite ID And Name Composite Price Extended Composite ID With Check Digit Date Encapsulated Data Formatted Text (Display) Money Numeric Person Name Reference Pointer Structured Numeric String Data. Time Telephone Number Time Stamp (Date & Time) Text Data (Display) Extended Address Extended Composite Name And Number For Persons Extended Composite Name And Number For Organizations Extended Person Number Extended Telecommunications Number 5.4 OBX-3 Observation identifier ID (CE) 00571 : 5F190143002315151^HSV-1 ( ) ID ID ( HL7 V2.3 8 ) 1 ( ) LOINC ( ) (LOINC http:// www. mcis. duke. edu/ standards/ termcode/ loinc.htm ) ASTM E1467 X2 OBX-4 Observation sub-id ID (ST) 00572 1 OBR OBX ID OBX 3 3 OBX (1 OBX ) OBX 1 ID 1 2 ID 2 3 ID 3 HL7 OBX 1 7 10 Copyright 1998 JAHIS V1.0 65
7-10. Example of sub-identifier usage OBR 1 88304&SURG PATH REPORT... OBX 1 CE 88304&ANT 1 T57000^GALLBLADDER^SNM... OBX 2 TX 88304&GDT 1 THIS IS A NORMAL GALLBLADDER... OBX 3 TX 88304&MDT 1 MICROSCOPIC EXAM SHOWS HISTOLOGICALLY NORMAL GALLBLADDER TISSUE... OBX 4 CE 88364&IMP 1 M-00100^NML^SNM... OBX 5 CE 88304&ANT 2 T66000^APPENDIX^SNM... OBX 6 TX 88304&GDT 2 THIS IS A RED, INFLAMED, SWOLLEN, BOGGY APPENDIX... OBX 7 TX 88304&MDT 2 INFILTRATION WITH MANY PMN's - INDICATING INFLAMATORY CHANGE... OBX 8 CE 88304&IMP 2 M-40000^INFLAMMATION NOS^SNM... 7-10 2 (2 1 ) 88304&ANT 2 88304&GDT 2 88304&MDT 2 1 2 ID (OBX ) ( D5W ) OBX HL7 1 OBX ID 1 OBX ID2 2 OBX null 1 OBX-5 Observation value (*) 00573 OBX 2 OBX ASCII ST SN ST 100 ( >100 ) 2+ SN >^100 ^2^+ SN OBX OBX 1 OBX OBX 6 OBX 8 OBX 9 4 OBX 2 ( ) X 2 OBX 2 OBX 1 OBX 2 ( ) 1 ( CE ) (1 ) ( ) 1 OBX ID ID OBX Copyright 1998 JAHIS V1.0 66
(CE) OBX 1 CE 1 OBX ID ID OBX ( / / OBX ) OBX6 12 OBX 3 OBX 4 ID OBX null ID ID OBX 1 OBX CE ( ) ( OBR 1 1 2 OBX OBR 2 1 2 OBX ) ( ) ID ( ) X CE 2 OBX 1 CE 71020&IMP 1 ^CONGESTIVE HEART FAILURE. OBX 1 CE 71020&IMP 1 ^CONGESTIVE HEART FAILURE AND PNEUMONIA OBX 1 CE 71020&IMP 1 ^CONGESTIVE HEART FAILURE OBX 2 CE 71020&IMP 2 ^PNEUMONIA. ( 2) ( ( 1) OBX-6 Units (CE) 00574 CE < (ASCII)(ST) > ^ < ( )(ST) > ^ < (L)(ST) > OBX-7 References range (ST) 00575 Components: : a) lower limit-upper limit (when both lower and upper limits are defined, e.g., for potassium 3.5-4.5) b) > lower limit (if no upper limit, e.g., >10) c) < upper limit (if no lower limit, e.g., <15) : OBX-8 Abnormal flags (ID) 00576 S R I MS VS ( ASTM 1238 ) 0078 Copyright 1998 JAHIS V1.0 67
X N A ( ) ( A W) 0078 Abnormal flags Value space L Below low normal H Above high normal LL Below lower panic limits HH Above upper panic limits < Below absolute low-off instrument scale > Above absolute high-off instrument scale N Normal (applies to non-numeric results) ( ) A Abnormal (applies to non-numeric results) ( ) AA Very abnormal (applies to non-numeric units, analagous to panic limits for numeric units) ( ) null No range defined, or normal ranges don't apply U Significant change up D Significant change down B Better--use when direction not relevant W Worse--use when direction not relevant For microbiology sensitivities only: S Sensitive R Resistant I Intermediate MS Moderately sensitive VS Very sensitive OBX-9 Probability (NM) 00577 ( ) 0 1(0 1 ) ASCII 10 OBX-10 Nature of abnormal test (ID) 00578 0080 0080 Nature of abnormal testing Value A N R S An age-based population None - generic normal range A race-based population A sex-based population OBX-11 Observ result status (ID) 00579 0085 1 Value C D F I P R S X U 0085 - Observation result status codes interpretation Record coming over is a correction and thus replaces a final result Deletes the OBX record OBX Final results; Can only be changed with a corrected result. Specimen in lab; results pending Preliminary results Results entered -- not verified Partial results Results cannot be obtained for this observation Results status change to Final. without retransmitting results already sent as preliminary. ( ) OBX-12 Effective date last obs normal value (TS) 00580 Copyright 1998 JAHIS V1.0 68
null ID ID OBX-13 User defined access checks (ST) 00581 ID ( ) ( HL7 OBX-14 Date-time of the observation (TS) 00582 2 1 (OBR) OBX 1 ( X ) OBX-15 Producer's ID ID (CE) 00583 ID null CLIA OBX-16 Responsible observer (XCN) 00584 ( ) ( CE OBX 15 ID OBX-17 Observation method (CE) 00936 OBX-18 Template indicator (CE) OBX OBR-4 C- D- B- D OBX-5 OBX-11 OBX-2 OBR-4 OBR OBX Copyright 1998 JAHIS V1.0 69
7. MERIT-9 MERIT-9: Medical Record Image Text - Information Exchange 7.1 MML(Medical Mark-up Language) MERIT-9(Medical Record Image Text - Information Exchange) SGML MML(Medical Mark-up Language) MML CLINICAL-ENCOUNTER-SECTION OBJECTIVE-SECTION JAHIS HL7 Ver2.3 ORU MML TEST-RESULT TYPE= LABORATORY MREF CONTENT-TYPE= APPLICATION/HL72.3-HL7ER2.3 EXAM-DATE= yyyymmdd REF= url (file://path name/file name.hl7) EXAM-DATE OBR-7 REF URL 8 HL7 7.2 MERIT-9 MML < CPR-MML > < MML-INFORMATION-SECTION >... < /MML-INFORMATION-SECTION > < PATIENT-ID-SECTION >... < /PATIENT-ID-SECTION > < CLINICAL-ENCOUNTER-SECTION >... < OBJECTIVE-SECTION >... < TEST-RESULT TYPE= LABORATRY > < MREF CONTENT-TYPE= APPLICATION/HL72.3-HL7ER2.3 EXAM-DATE= 19970523 REF= file://pid001/oal001.hl7 > ------------------- HL7 ORU Message < MREF CONTENT-TYPE= APPLICATION/HL72.3-HL7ER2.3 EXAM-DATE= 19970523 REF= file://pid001/oal002.hl7 > ------------------- HL7 ORU Message < /TEST-RESULT >... < /OBJECTIVE-SECTION >... < PLAN-SECTION >... < TEST-ORDER... >... < /TEST-ORDER >... < /PLAN-SECTION >... < /CLINICAL-ENCOUNTER-SECTION >... < /CPR-MML > MML/MERIT-9 http://www.h.u-tokyo.ac.jp/mml/ Copyright 1998 JAHIS V1.0 70