HL7 ORU Message
The HL7 ORU-R01 message transmits observations and results from the producing system/filler i.e. LIS, EKG system) to the ordering system/placer (i.e. HIS, physician office application). It may also be used to transmit result data from the producing system to a medical record archival system, or to another system not part of the original order process. ORU messages are also sometimes used to register or link to clinical trials, or for medical reporting purposes for drugs and devices.
Types of observations reported in the ORU-R01 message include:
- Clinical lab results
- Imaging study reports
- EKG pulmonary function study results
- Patient condition or other data (i.e. vital signs, symptoms, allergies, notes, etc.)
The ORU message is a structured report where each observation is separated into an individual entity, and then separated into fields. ORU messages do not carry images; they use varying data types but most often use text, numbers and codes.
In the ORU message, the OBR (Observation request) and OBX (Observation) segments are most significant due to their functions:
- The HL7 OBR segment is used in all ORU messages as a report header, and contains important information about the order being fulfilled (i.e. order number, request date/time, observation date/time, ordering provider, etc.). This segment is part of a group that can be used more than once for each observation result that is reported in the message.
- The HL7 OBX segment transmits the actual clinical observation results as a single observation or observation fragment. OBX segments can also be used more than once in the message, and may be followed by one or more NTE segments to provide additional notes and comments about the observation.
| SEGMENT/GROUP | NAME | OPTIONAL/REPEATABLE? |
|---|---|---|
| MSH | Message header | Required |
| ResultsGroup – Repeatable group, includes groups that follow (unless otherwise noted): | ||
| PatientGroup – Optional group | ||
| PID | Patient identification | Required |
| PID1 | Patient demographics | Optional |
| NTE | Notes and comments | Optional, Repeatable |
| PatientVisitGroup – Optional group, part of PatientGroup | ||
| PV1 | Patient visit | Required |
| PV2 | Patient visit – additional info | Optional |
| OrderGroup – Repeatable group | ||
| ORC | Common order | Optional |
| OBR | Observation request | Required |
| NTE-1 | Notes and comments | Optional, Repeatable |
| ObservationGroup –Repeatable group, part of OrderGroup | ||
| OBX | Observation | Optional |
| NTE-2 | Notes and comments | Optional, Repeatable |
| OrderGroup continued | ||
| CTI | Clinical trial identification | Optional, Repeatable |
| Additional segment, not part of a group: | ||
| DSC | Continuation pointer segment | Optional |
In HL7 pipe and hat format, an ORU-R01 message would look like this (each OBR segment is shown in blue, each OBX segment is shown in red):
MSH|^~\&|LCS|LCA|LIS|TEST9999|199807311532||ORU^R01|3629|P|2.2
PID|2|2161348462|20809880170|1614614|20809880170^TESTPAT||19760924|M|||^^^^
00000-0000|||||||86427531^^^03|SSN# HERE
ORC|NW|8642753100012^LIS|20809880170^LCS||||||19980727000000|||HAVILAND
OBR|1|8642753100012^LIS|20809880170^LCS|008342^UPPER RESPIRATORY
CULTURE^L|||19980727175800||||||SS#634748641 CH14885 SRC:THROA
SRC:PENI|19980727000000||||||20809880170||19980730041800||BN|F
OBX|1|ST|008342^UPPER RESPIRATORY CULTURE^L||FINALREPORT|||||N|F||| 19980729160500|BN
ORC|NW|8642753100012^LIS|20809880170^LCS||||||19980727000000|||HAVILAND
OBR|2|8642753100012^LIS|20809880170^LCS|997602^.^L|||19980727175800||||G|||
19980727000000||||||20809880170||19980730041800|||F|997602|||008342
OBX|2|CE|997231^RESULT 1^L||M415|||||N|F|||19980729160500|BN
NTE|1|L|MORAXELLA (BRANHAMELLA) CATARRHALIS
NTE|2|L| HEAVY GROWTH
NTE|3|L| BETA LACTAMASE POSITIVE
OBX|3|CE|997232^RESULT 2^L||MR105|||||N|F|||19980729160500|BN
NTE|1|L|ROUTINE RESPIRATORY FLORA