Outbound ######## The Unsolicited Observation HL7 message is sent to other HL7 applications/receivers if HL7 receivers are to be notified about the availability of the imaging results using `Encounter-Based Imaging Workflow (EBIW) - Notify of Imaging Results [RAD-132] `_. This notification can be triggered on receive of studies either by : - DICOM Studies stored conforming to `Storage AE Specification `_ - DICOM Studies / Bulkdata stored using `STOW-RS Services `_ - `Reports stored by HL7 ORU `_ .. _oru_out_messages: Outbound Messages ================= .. _oru_out_oru_r01: ORU - Unsolicited Observation Message (Event R01) ------------------------------------------------- Supported HL7 version: 2.5.1 (RAD-128) Trigger Event ^^^^^^^^^^^^^ This message is sent out by the archive : - when study received by the archive and notification about availability of imaging results is configured. Supported Segments ^^^^^^^^^^^^^^^^^^ The following segments are sent in an outgoing ORU^R01^ORU_R01 message: .. csv-table:: Supported segments of ORU^R01^ORU_R01 (HL7 v2.5.1) :header: Segment, Meaning, Usage, Card., HL7 chapter :widths: 15, 40, 15, 15, 15 MSH - :ref:`tab_msh_251`, Message Header, R, [1..1], 2 PID - :ref:`tab_pid_251_out`, Patient Identification, R, [1..1], 3 NTE - :ref:`tab_nte_251_out`, Notes and Comments (for PID), O, [0..1], 2 PV1 - :ref:`tab_pv1_oru_251`, Patient Visit, R, [1..1], 3 ORC - :ref:`tab_orc_oru_251`, Common Order, O, [1..1], 4 TQ1 - :ref:`tab_tq1_oru_251`, Timing and Quantity, R, [1..1], 4 OBR - :ref:`tab_obr_oru_251`, Order Request Segment, R, [1..1], 7 OBX - :ref:`tab_obx_oru_251`, Observation Result Segment, R, [1..1], 7 Expected Actions ^^^^^^^^^^^^^^^^ The Receiver shall accept and process the message.The Receiver shall support receiving multiple imaging result messages for the same DICOM Study Instance UID. That is, multiple imaging Series may each result in a separate notification message despite being part of a single DICOM Study. Receiver actions subsequent to receiving an image result will depend on internal business logic and/or the profile in which the transaction is being performed. .. _oru_out_segments: Outbound Message Segments ========================= .. _oru_out_msh: MSH - Message Header segment ---------------------------- Same as specified in :ref:`tab_msh_251` .. _oru_out_pid: PID - Patient Identification segment ------------------------------------ Same as specified in :ref:`tab_pid_251_out` .. _oru_out_nte: NTE - Notes and Comments segment for (PID) ------------------------------------------ Same as specified in :ref:`tab_nte_251_out` .. _oru_out_pv1: PV1 - Patient Visit segment --------------------------- .. csv-table:: PV1 - Patient Visit segment (HL7 v2.5.1) :name: tab_pv1_oru_251 :header: SEQ, LEN, DT, OPT, TBL#, ITEM #, Element Name :widths: 8, 8, 8, 8, 8, 12, 48 1, 4, SI, O, , 01627, Set ID - PV1 2, 1, IS, R, , 00132, **Patient Class** 3, 80, PL, C, , 00133, Assigned Patient Location 4, 2, IS, O, 0007, 00134, Admission Type 5, 20, CX, O, , 00135, Preadmit Number 6, 80, PL, O, , 00136, Prior Patient Location 7, 60, XCN, C, 0010, 00137, Attending Doctor 8, 60, XCN, C, 0010, 00138, Referring Doctor 9, 60, XCN, R2, 0010, 00139, Consulting Doctor 10, 3, IS, C, 0069, 00140, Hospital Service 11, 80, PL, O, , 00141, Temporary Location 12, 2, IS, O, 0087, 00142, Preadmit Test Indicator 13, 2, IS, O, 0092, 00143, Readmission Indicator 14, 3, IS, O, 0023, 00144, Admit Source 15, 2, IS, C, 0009, 00145, Ambulatory Status 16, 2 , IS, O, 0099, 00146, VIP Indicator 17, 60, XCN, C, 0010, 00147, Admitting Doctor 18, 2, IS, O, 0018, 00148, Patient Type 19, 20, CX, C, , 00149, **Visit Number** 20, 50, FC, O, 0064, 00150, Financial Class 21, 2, IS, O, 0032, 00151, Charge Price Indicator 22, 2, IS, O, 0045, 00152, Courtesy Code 23, 2, IS, O, 0046, 00153, Credit Rating 24, 2, IS, O, 0044, 00154, Contract Code 25, 8, DT, O, , 00155, Contract Effective Date 26, 12, NM, O, , 00156, Contract Amount 27, 3, NM, O, , 00157, Contract Period 28, 2, IS, O, 0073, 00158, Interest Code 29, 1, IS, O, 0110, 00159, Transfer to Bad Debt Code 30, 8, DT, O, , 00160, Transfer to Bad Debt Date 31, 10, IS, O, 0021, 00161, Bad Debt Agency Code 32, 12, NM, O, , 00162, Bad Debt Transfer Amount 33, 12, NM, O, , 00163, Bad Debt Recovery Amount 34, 1, IS, O, 0111, 00164, Delete Account Indicator 35, 8, DT, O, , 00165, Delete Account Date 36, 3, IS, O, 0112, 00166, Discharge Disposition 37, 25, CM, O, 0113, 00167, Discharge to Location 38, 80, CE, O, 0114, 00168, Diet Type 39, 2, IS, O, 0115, 00169, Servicing Facility 40, 1, IS, O, 0116, 00170, Bed Status 41, 2, IS, O, 0117, 00171, Account Status 42, 80, PL, O, , 00172, Pending Location 43, 80, 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, 0203, 00180, Alternate Visit ID 51, 1, IS, C, 0326, 01226, **Visit Indicator** 52, 60, XCN, O, 0010, 01224, Other Healthcare Provider .. _oru_out_orc: ORC - Order Control segment --------------------------- .. csv-table:: ORC - Order Control segment (HL7 v2.5.1) :name: tab_orc_oru_251 :header: SEQ, LEN, DT, OPT, TBL#, ITEM #, Element Name :widths: 8, 8, 8, 8, 8, 12, 48 1, 2, ID, R, 0119, 00215, **Order Control** 2, 22, EI, R, , 00216, **Placer Order Number** 3, 22, EI, X, , 00217, **Filler Order Number** 4, 22, EI, C, , 00218, Placer Group Number 5, 2, ID, O, 0038, 00219, **Order Status** 6, 1, ID, O, 0121, 00220, Response Flag 7, 200, TQ, X, , 00221, Quantity/Timing 8, 200, EIP, C, , 00222, Parent 9, 26, TS, O, , 00223, Date/Time of Transaction 10, 250, XCN, O, , 00224, Entered By 11, 250, XCN, O, , 00225, Verified By 12, 250, XCN, O, , 00226, Ordering Provider 13, 80, PL, O, , 00227, Enterer's Location 14, 250, XTN, O, , 00228, Callback Phone Number 15, 26, TS, O, , 00229, Order Effective Date/Time 16, 250, CE, O, , 00230, Order Control Code Reason 17, 250, CE, O, , 00231, Entering Organization 18, 250, CE, O, , 00232, Entering Device 19, 250, XCN, O, , 00233, Action By 20, 250, CE, O, 0339, 01310, Advanced Beneficiary Notice Code 21, 250, XON, O, , 01311, Ordering Facility Name 22, 250, XAD, O, , 01312, Ordering Facility Address 23, 250, XTN, O, , 01313, Ordering Facility Phone Number 24, 250, XAD, O, , 01314, Ordering Provider Address 25, 250, CWE, O, , 01473, Order Status Modifier 26, 60, CWE, C, 0552, 01641, Advanced Beneficiary Notice Override Reason 27, 26, TS, O, , 01642, Filler's Expected Availability Date/Time 28, 250, CWE, O, 0177, 00615, Confidentiality Code 29, 250, CWE, O, 0482, 01643, Order Type 30, 250, CNE, O, 0483, 01644, Enterer Authorization Mode 31, 250, CWE, O, , 02286, Parent Universal Service Identifier .. _oru_out_tq1: TQ1 - Timing/Quantity segment ----------------------------- .. csv-table:: TQ1 - Timing/Quantity segment (HL7 v2.5.1) :name: tab_tq1_oru_251 :header: SEQ, LEN, DT, OPT, TBL#, ITEM #, Element Name :widths: 8, 8, 8, 8, 8, 12, 48 1, 4, SI, O, , 01627, Set ID - TQ1 2, 20, CQ, O, , 01628, Quantity 3, 540, RPT, O, 0335, 01629, Repeat Pattern 4, 20, TM, O, , 01630, Explicit Time 5, 20, CQ, O, , 01631, Relative Time and Units 6, 20, CQ, O, , 01632, Service Duration 7, 26, TS, R, , 01633, **Start Date/Time** 8, 26, TS, O, , 01634, End Date/Time 9, 250, CWE, O, 0485, 01635, **Priority** 10, 250, TX, O, , 01636, Condition Text 11, 250, TX, O, 0065, 01637, Text Instruction 12, 10, ID, C, 0472, 01638, Conjunction 13, 20, CQ, O, , 01639, Occurrence Duration 14, 10, NM, O, , 01640, Total Occurrences .. _oru_out_obr: OBR - Observation Request segment --------------------------------- .. csv-table:: OBR - Observation Request segment (HL7 v2.5.1) :name: tab_obr_oru_251 :header: SEQ, LEN, DT, OPT, TBL#, ITEM #, Element Name :widths: 8, 8, 8, 8, 8, 12, 48 1, 4, SI, O, , 00237, SetID - OBR 2, 22, EI, R2, , 00216, **Placer Order Number** 3, 22, EI, R2, , 00217, **Filler Order Number** 4, 250, CE, R, , 00238, **Universal Service ID** 5, 2, ID, X, , 00239, Priority (retired) 6, 26, TS, X, , 00240, Requested Date/Time 7, 26, TS, R, , 00241, **Observation Date/Time** 8, 26, TS, O, , 00242, Observation End Date/Time 9, 20, CQ, O, , 00243, Collection Volume 10, 250, XCN, O, , 00244, Collection Identifier 11, 1, ID, O, 0065, 00245, Specimen Action Code 12, 250, CE, X, , 00246, Danger Code 13, 300, ST, C, , 00247, Relevant Clinical Info 14, 26, TS, X, , 00248, Specimen Received Date/Time 15, 300, SPS, X, 0070, 00249, Specimen Source 16, 250, XCN, O, , 00226, Ordering Provider 17, 250, XTN, O, , 00250, Order Callback Phone Number 18, 60, ST, R, , 00251, **Placer Field 1** 19, 60, ST, R2, , 00252, **Placer Field 2** 20, 60, ST, O, , 00253, Filler Field 1 21, 60, ST, O, , 00254, Filler Field 2 22, 26, TS, O, , 00255, Results Rpt/Status Chng - Date/Time 23, 40, MOC, O, , 00256, Charge to Practice 24, 10, ID, R, 0074, 00257, **Diagnostic Service Sect ID** 25, 1, ID, R, 0123, 00258, **Result Status** 26, 400, PRL, O, , 00259, Parent Result 27, 200, TQ, R, , 00221, **Quantity/Timing** 28, 250, XCN, O, , 00260, Result Copies To 29, 200, EIP, C, , 00261, Parent 30, 20, ID, O, 0124, 00262, Transportation Mode 31, 250, CE, R2, , 00263, **Reason For Study** 32, 200, NDL, R2, , 00264, Principal Result Interpreter 33, 200, NDL, R2, , 00265, Assistant Result Interpreter 34, 200, NDL, R2, , 00266, **Technician** 35, 200, NDL, O, , 00267, Transcriptionist 36, 26, TS, O, , 00268, Scheduled Date/Time 37, 4, NM, O, , 01028, Number of Sample Containers 38, 250, CE, O, , 01029, Transport Logistics of Collected Sample 39, 250, CE, O, , 01030, Collector's Comment 40, 250, CE, O, , 01031, Transport Arrangement Responsibility 41, 30, ID, O, 0224, 01032, Transport Arranged 42, 1, ID, O, 0225, 01033, Escort Required 43, 250, CE, O, , 01034, Planned Patient Transport Comment 44, 250, CE, R, 0088, 00393, **Procedure Code** 45, 250, CE, O, 0340, 01036, Procedure Code Modifier 46, 250, CE, O, 0411, 01474, Placer Supplemental Service Information 47, 250, CE, O, 0411, 01475, Filler Supplemental Service Information 48, 250, CWE, O, 0476, 01646, Medically Necessary Duplicate Procedure Reason 49, 2, IS, O, 0507, 01647, Result Handling 50, 250, CWE, O, , 02286, Parent Universal Service Identifier .. _oru_out_obx: OBX - Observation Result segment -------------------------------- .. csv-table:: OBX - Observation Result segment (HL7 v2.5.1) :name: tab_obx_oru_251 :header: SEQ, LEN, DT, OPT, TBL#, ITEM #, Element Name :widths: 8, 8, 8, 8, 8, 12, 48 1, 4, SI, O, , 00569, **SetID - OBX** 2, 2, ID, C, 0125, 00570, **Value Type** 3, 250, CE, R, , 00571, **Observation Identifier** 4, 20, ST, C, , 00572, Observation Sub-ID 5, 99999^1, varies, C, , 00573, **Observation Value** 6, 250, CE, O, , 00574, Units 7, 60, ST, O, , 00575, References Range 8, 5, IS, O, 0078, 00576, Abnormal Flags 9, 5, NM, O, , 00577, Probability 10, 2, ID, O, 0080, 00578, Nature of Abnormal Test 11, 1, ID, R, 0085, 00579, **Observation Result Status** 12, 26, TS, O, , 00580, Effective Date of Reference Range 13, 20, ST, O, , 0581, User Defined Access Checks 14, 26, TS, O, , 00582, Date/Time of Observation 15, 250, CE, O, , 00583, Producer's ID 16, 250, XCN, O, , 00584, Responsible Observer 17, 250, CE, O, , 00936, Observation Method 18, 22, EI, O, , 01479, Equipment Instance Identifier 19, 26, TS, O, , 01480, Date/Time of the Analysis Element names in **bold** indicates that the field is used by |product|. .. _oru_out_dicom: DICOM to HL7 Unsolicited Observation Message Mapping ==================================================== Mappings between HL7 and DICOM are illustrated in the following manner: - Element Name (HL7 item_number.component.sub-component #/ DICOM (group, element)) - The component/sub-component value is not listed if the HL7 element should not contain multiple components/sub-components. .. _oru_out_oru_r01_dicom: ORU - DICOM Image Attributes to HL7 Unsolicited Observation Message mapping --------------------------------------------------------------------------- .. csv-table:: DICOM Image Attributes to HL7 Unsolicited Observation Message mapping :name: dicom_to_oru :header: DICOM Attribute, DICOM Tag, HL7 Field, HL7 Item #, HL7 Segment, Note Specific Character Set, "(0008, 0005)", Character Set, 00692, MSH:18, :ref:`tab_hl7_dicom_charset` Patient's Name, "(0010, 0010)", Patient Name, 00108, PID:5 Patient ID, "(0010, 0020)", Patient Identifier List, 00106.1, PID:3.1 Issuer of Patient ID, "(0010, 0021)", Patient Identifier List, 00106.4.1, PID:3.4.1 Issuer of Patient ID Qualifiers Sequence, "(0010, 0024)" >Item, "(FFFE, E000)" >Universal Entity ID, "(0040, 0032)", Patient Identifier List, 00106.4.2, PID:3.4.2 >Universal Entity ID Type, "(0040, 0033)", Patient Identifier List, 00106.4.3, PID:3.4.3 Other Patient IDs Sequence, "(0010,1002)", Patient Identifier List, 00106, PID:3, [#Note10]_ Patient's Birth Date, "(0010, 0030)", Date/Time of Birth, 00110, PID:7 Patient's Sex, "(0010, 0040)", Administrative Sex, 00111.1, PID:8.1 Patient Comments, "(0010, 4000)", Comment, 00098, NTE:3 Route of Admissions, "(0038, 0016)", Patient Class, 00132, PV1:2, [#Note9]_ Admission ID, "(0038, 0010)", Visit Number, 00149.1, PV1:19.1 Issuer of Admission ID Sequence, "(0038, 0014)" >Item, "(FFFE, E000)" >Local Namespace Entity ID, "(0040, 0031)", Visit Number, 00149.4.1, PV1:19.4.1 >Universal Entity ID, "(0040, 0032)", Visit Number, 00149.4.2, PV1:19.4.2 >Universal Entity ID Type, "(0040, 0033)", Visit Number, 00149.4.3, PV1:19.4.3 , , Visit Indicator, 01226, PV1:51, Set to V , , Order Control, 00215, ORC:1, Set to SC , , Order Status, 00219, ORC:5, Set to CM , , Start Date/Time, 01633, TQ1:7, [#Note1]_ , , Start Date/Time, 01633, TQ1:7, [#Note1]_ Accession Number, "(0008, 0050)", Placer Field 1, 00251, OBR:18 Issuer of Accession Number Sequence, "(0008, 0051)", Placer Field 1 #, 00251, OBR:18, [#Note8]_ Requested Procedure ID, "(0040,1001)", Placer Field 2 #, 00252, OBR:19, Placer Issuer and Number, "(0040, 2016)", Placer Order #, 00216.1, ORC:2.1 Order Placer Identifier Sequence, "(0040, 0026)" >Local Namespace Entity ID, "(0040, 0031)", Placer Order #, 00216.2, ORC:2.2 >Universal Entity ID, "(0040, 0032)", Placer Order #, 00216.3, ORC:2.3 >Universal Entity ID Type, "(0040, 0033)", Placer Order #, 00216.4, ORC:2.4 Filler Issuer and Number, "(0040, 2017)", Filler Order #, 00217.1, ORC:3.1 Order Filler Identifier Sequence, "(0040, 0027)" >Local Namespace Entity ID, "(0040, 0031)", Filler Order #, 00217.2, ORC:3.2 >Universal Entity ID, "(0040, 0032)", Filler Order #, 00217.3, ORC:3.3 >Universal Entity ID Type, "(0040, 0033)", Filler Order #, 00217.4, ORC:3.4 , , Priority, 01635, TQ1:9, Set to R^Routine^HL70078 , , Quantity/Timing, 00221, OBR:27, Set to ^^^^^R , , Universal Service ID, 00238, OBR:4, [#Note2]_ , , Observation Date/Time, 00241, OBR:7, [#Note3]_ Institutional Department Type Code Sequence, "(0008, 1041)" >Code Value, "(0008, 0100)", Diagnostic Service Sect ID #, 00257, OBR:24, [#Note7]_ , , Result Status, 00258, OBR:25, Set to R , , Reason For Study, 00263, OBR:31, [#Note4]_ , , Technician, 00266, OBR:34, [#Note5]_ , , Procedure Code, 00393, OBR:44, [#Note6]_ , , SetID - OBX, 00569, OBX:1, Set to 1 , , Value Type, 00570, OBX:2, Set to ST , , Observation Identifier, 00571, OBX:3, Set to 113014^DICOM Study^DCM Study Instance UID, "(0020, 000D)", Observation Value, 00573, OBX:5 , , Observation Result Status, 00579, OBX:11, Set to O .. [#Note1] This value is populated from the created time of the task. (The `task` here refers to a task created in database for sending out the HL7 notification.) .. [#Note2] This field shall contain a procedure code in the first three components: OBR-4.1 Identifier, OBR-4.2 text code meaning, OBR-4.3 coding system. The use of codes from a standardized coding system for procedures, such as the RadLex Playbook LOINC codes, is 1385 recommended. In order of preference, the procedure code may be taken from: - Procedure Code Sequence (0008,1032) - Requested Procedure Code Sequence (0032,1064) .. [#Note3] Observation Date/Time shall contain a date/time representative of the imaging procedure. When choosing the date/time to use, consider that an EMR might use this date/time to find other clinical entries for the patient at or near this time which might provide context for the imaging procedure. The date/time might be taken from one of the following attributes in the associated DICOM image objects: - Study Date (0008,0020) & Study Time (0008,0030) - Series Date (0008,0021) & Series Time (0008,0031) .. [#Note4] This field shall be valued, if known. This might be taken from one of the following attributes in the associated DICOM image objects: - Reason for Performed Procedure Code Sequence (0040,1012) - Reason for the Requested Procedure (0040,1002) or Code Sequence (0040,100A)1425 - Reason for Visit (0032,1066) or Code Sequence (0032,1066) - Admitting Diagnoses Description (0008,1080) or Code Sequence (0008,1084) .. [#Note5] This field shall be valued, if the person who acquired the images is known. This might be taken from one of the following attributes in the associated DICOM image objects: - Operators' Name (0008,1070) or Operator Identification Sequence (0008,1072) - Performing Physician's Name (0008,1050) or Performing Physician Identification Sequence (0008,1052) .. [#Note6] Procedure Code shall match OBR-4. .. [#Note7] Value set to `RAD` as fallback, if no `Institutional Department Type Code Sequence (0008, 1041)` found in the object's attributes. .. [#Note8] As `Encoding of Assigning Authority in ST data field OBR-19 needs to be clarified `_ and `it has been captured into Change Proposals `_, temporarily the `HL7v2 Hierarchic Designator Macro Attributes `_ of `Issuer Of Accession Number Sequence` have been encoded as per `Example 3: ISO OID encoded in an ST subcomponent `_ .. [#Note9] Route of Admissions (0038, 0016) DICOM attribute, if present, shall be mapped to PV1:2. If this DICOM attribute is absent, default "U" (denoting Patient Class as Unknown) shall be used. .. [#Note10] Each **Other Patient IDs Sequence (0010,1002)** item is populated in patient identifiers list in the specified segment field separated using **Repetition Separator ~**