6. Result Message Types (MT-ORU-1, MT-ORU-2, MT-ORU-3)
6.4. ORC – Common Order Segment
The Common Order segment (ORC) is used to transmit fields that are common to all of the tests ordered in a single lab requisition. Although the ORC segment is more commonly used to communicate
information in the course of ordering tests, it may also be used in messages that report test results (such as ORU messages).
6.4.6. ORC Segment Structure
HL7 Attribute Table – ORC – Common Order
SEQ ELEMENT NAME LEN DT Usage Cardinality Comment/
Description
1 Order Control 2 ID R [1..1] 6.4.7
2 Placer Order Number 22 EI R [1..1] 6.4.8
3 Filler Order Number 22 EI X [0..0]
4 Placer Group Number 22 EI X [0..0]
5 Order Status 2 ID R [1..1] 6.4.9
6 Response Flag 1 ID X [0..0]
7 Quantity/Timing 200 TQ X [0..0]
8 Parent 200 CM X [0..0]
9 Date/Time of Transaction 26 TS X [0..0]
10 Entered By 250 XCN X [0..0]
11 Verified By 250 XCN X [0..0]
12 Ordering Provider 250 XCN X [0..0]
13 Enterer’s Location 80 PL X [0..0]
14 Call Back Phone Number 250 XTN X [0..0]
15 Order Effective Date/Time 26 TS X [0..0]
16 Order Control Code Reason 250 CE X [0..0]
17 Entering Organization 250 CE X [0..0]
18 Entering Device 250 CE X [0..0]
19 Action By 250 XCN X [0..0]
20 Advanced Beneficiary Notice Code 250 CE X [0..0]
21 Ordering Facility Name 250 XON X [0..0]
22 Ordering Facility Address 250 XAD X [0..0]
23 Ordering Facility Phone Number 250 XTN X [0..0]
24 Ordering Provider Address 250 XAD X [0..0]
25 Order Status Modifier 250 CWE X [0..0]
6.4.7. ORC-1 Order Control (ID)
HL7 Definition: Determines the function of the common order segment. The value of this field varies depending on the specific message type in which the ORC segment appears and the trigger event for the message instance. Refer to HL7 Table 0119 - Order control codes and their meaning for valid entries.
Note: This table does not appear in Appendix B. See the HL7 v2.4 specification for details.
CALINX Specification: This is a required field per the HL7 specification. When the ORC segment appears in messages of the following ELINCS message types:
MT-ORU-1 MT-ORU-2 MT-ORU-3
then the required value of ORC-1 Order Control is:
RE
6.4.8. ORC-2 Placer Order Number (EI)
HL7 Definition: This field contains the order number as assigned by the placer (EHR application). The first component is a string that identifies the individual order. It identifies an order uniquely among all orders from a particular ordering application.
EI Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^
<universal ID (ST)> ^ <universal ID type (ID)>
ELINCS Specification: The value of placer order number must contain the order identifier specified on the lab requisition (order) received by the laboratory. Per the ELINCS specification, lab requisitions must contain an order identifier as assigned by the EHR system, and the order identifier must be recorded by the laboratory upon receipt and maintained throughout processing of the ordered test(s) (see Section 5.1.1). The order identifier must subsequently appear as the placer order number (within the ORC and OBR segments) in all communications from the laboratory to the EHR system that relate to the status or the results of any of the test(s) ordered on the requisition.
The nature of the order identifier that is specified is at the discretion of the EHR system that generates the requisition (recall that the ELINCS use case requires that lab requisitions are generated via an EHR system). Specifically, it is NOT assumed or required that the order identifier is unique beyond the namespace of the EHR system. Hence, no value is required for the <namespace ID>, <universal ID> or
<universal ID type> components of this field unless a value has been specified on the lab requisition (order), in which case, the value(s) specified must be reported in the placer order number field . It is incumbent on the EHR system that generates lab requisitions and receives lab results to manage the order identifiers that appear in these communications appropriately. Laboratories are responsible only for correctly recording the order identifiers as they have been specified in the lab requisition and including them in any status messages or reported results.
Note: The placer order number is assigned to an entire lab requisition, which may contain multiple ordered tests. Hence, the value of placer order number will be the same in each ORC and OBR segment that reports the status or the results of tests ordered per that requisition (See also OBR-2 Placer Order Number).
Special Case: In reporting the status or results of reflex tests or add-on tests (see Section 6.5.7), the placer order number associated with the original lab requisition should be placed in the Placer Order Number field of the ORC segment.
Note: The value of the <entity identifier> component is not necessarily numeric (the data type ST allows alphanumeric characters).
Field: OBR-2 Placer Order Number (EI)
Component/Sub-Component Usage
entity identifier (ST) R
namespace ID (IS) C
universal ID (ST) C
universal ID type (ID) C
ELINCS Sample Value(s):
ORD885-04A3X [The order identifier as provided on the
lab requisition]
48577689599^ACME^252 [The order identifier as provided on the lab requisition, including the namespace ID and universal ID]
6.4.9. ORC-5 Order Status (ID)
The usage of this field depends on the specific interaction and message type in which it appears. See the sub-sections below for details.
HL7 Definition: The purpose of this field is to report the status of an order. It does not initiate action.
It is assumed that the order status always reflects the status as it is known to the sending application at the time that the message is sent. Only the filler can originate the value of this field.
ELINCS Specification: This field is intended to communicate the status of an entire lab requisition, which may consist of multiple tests. The primary purpose of the field is to indicate to the receiving system whether all of the tests ordered on a requisition have been processed to their completion (i.e., whether the lab requisition is “complete”) or whether the receiving system may expect to receive further results and/or status reports for some tests on the requisition (i.e., whether the lab requisition is still “in process”). The values allowed per HL7 appear in Table 0038 of Appendix B.
6.4.9.1. ORC-5 in Message Type MT-ORU-1 (Result Status interaction)
The following values should be assigned by the sending system for the indicated trigger events:Trigger Event Correct Value of
Order Status
Specimen received in laboratory IP Entire test cancelled* IP or CM
* The cancellation of a test does not necessarily imply that the entire order (requisition) has been cancelled, because multiple tests may be ordered on one requisition. Information in the OBR segments (specifically, OBR-25 Result Status) will indicate which specific test(s) have been cancelled. If only some of the tests in the order are cancelled, then the value IP should be placed in the Order Status field. If all of the outstanding tests on a requisition are cancelled, then the value CM should be placed in the Order Status field (to indicate that the processing of the lab requisition has concluded); In this case, an OBR segment indicating cancellation should also be sent for each outstanding test that has been cancelled.
6.4.9.2. ORC-5 in Message Type MT-ORU-2 (Result Available interaction)
The following values should be assigned by the sending system for the indicated trigger events:Trigger Event Correct Value of
Order Status
Preliminary results available IP
Final results available IP or CM *
Partial Cancellation IP or CM *
* If there remain any tests that have not been reported as Final and that have not been cancelled, then an Order Status of IP should be reported. If no such tests remain, then an Order Status of CM should be reported.
6.4.9.3. ORC-5 in Message Type MT-ORU-3 (Result Correction interaction)
The following values should be assigned by the sending system for the indicated trigger events:Trigger Event Correct Value of
Order Status
Corrections to previously reported results IP or CM *
Deletions of previously reported results IP or CM *
* If there remain any tests that have not been reported as Final and that have not been cancelled, then an Order Status of IP should be reported. If no such tests remain, then an Order Status of CM should be reported.
The OBR segment serves as the report header for the set of observations (analytes) related to a laboratory test. The details of each individual observation appear in corresponding OBX segments (see Section 6.7).
Universal Service Identifier 250 R [1..1]
5 2 ID [0..0]