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Incoming Orders from CPOE

1
Systems Interface Technical

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E6
Specification

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Epic 2015
Last Updated: February 8, 2016
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Epic | 1979 Milky Way | Verona, WI 53593 | Voice: 608.271.9000 | Fax: 608.271.7237 | www.epic.com | documentation@epic.com
2015 - 2016 Epic Systems Corporation. Contains information that is confidential and/or subject to restrictions on use and disclosure.
 D1
Table of Contents
1 Message Specifications ............................................................................................................................. 3

10
1.1 ORM^O01 General Order Message .................................................................................................................................. 3

89
1.2 Message Format for Event Type O01 ................................................................................................................................ 3
1.2.1 Notes on Format of ORM^O01 .......................................................................................................................................................... 4

20
2 Sample Messages ...................................................................................................................................... 5
2.1 Example Message for Event Types O01 ........................................................................................................................... 5

2E
2.1.1 Format Example .................................................................................................................................................................................. 5

3 Supported Segments and Fields .............................................................................................................. 6

1
-B
3.1 BHS Batch Header ............................................................................................................................................................ 6
3.2 MSH Message Header ..................................................................................................................................................... 6

E6
3.3 PID Patient Identification ................................................................................................................................................ 8
3.4 NTE Notes Following PID ............................................................................................................................................ 11

AA
3.5 PV1 Patient Visit ............................................................................................................................................................. 11
3.6 ORC Order Common ..................................................................................................................................................... 14
3.7 OBR Observation Reports ............................................................................................................................................. 15

D-
3.8 NTE Notes Following OBR ........................................................................................................................................... 19
3.9 DG1 Diagnosis ................................................................................................................................................................ 20
A2
3.10 OBX Observation .......................................................................................................................................................... 20
3.11 NTE Notes Following OBX ......................................................................................................................................... 21
4

3.12 ZRQ - Custom REQ Master File Item ........................................................................................................................... 22

0-

3.13 BTS Batch Trailer .......................................................................................................................................................... 22

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 1
Message Specifications 1 0D
1

8 9
2 0
This document can be shared with third parties to assist with interface implementation.
2 E
B 1
The interface is a subset of the full standard as defined in the published normative HL7 documentation coinciding with
the released software version. It may not support the entire HL7 specification, depending on functional needs.

6 -
1.1 ORM^O01 General Order Message
AE
- A
The ORM message is currently used only to indicate externally initiated new orders, order cancellations, status changes and
replacement orders
2D
1.2 Message Format for Event Type O01 A
- 4
ORM
E 0 General Order Message Chapter
MSH
F 5 Message Header 2
PID
F - Patient Identification 3
[{NTE}]
1F Notes and Comments 2
[PV1]
15 Patient Visit 3
{ORC

9 C Order Common 4
OBR
[{NTE}] : 5 Observation Reports
Notes and Comments
4
2
[{DG1}] ID Diagnosis 6
[{OBX
U U Observation Notes 7

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ORM General Order Message Chapter
1 0D
[{NTE}] Notes and Comments 2
8 9
}]}
2 0
ACK General Acknowledgment Chapter
2 E
MSH Message Header 2
B 1
MSA
6 -Message Acknowledgment 2
[ERR]
AE Error Information 2

1.2.1 Notes on Format of ORM^O01 - A

2D
When the interface receives an ORM^O01 message with an order code of CA, it can be configured to reply with an outgoing message

A
over the Outgoing Clinical Lab Results Interface. The message has an event of ORR^O02 and an order code of CR, as defined in the
4
-
related document Epic's Standard HL7 Outgoing Clinical Lab Results Interface.

0
should be filed.
5E
The interface does not create patients; PID information is used to locate and validate the patient to which the order information

- F
Items marked as "C" in the Epic column are workflow dependent

F F
The optional NTE segments following the OBR segment are treated as orderable-level comments.

5 1
The optional NTE segments following the OBX segment are treated as order question comments and will be filed with the

1
question/answer that immediately precedes them.
C
59
All date and timestamp fields use the standard HL7 Date/Time format. However, the interface will ignore any values beyond the
minutes field (i.e. seconds, time zones, etc.).

D :
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Sample Messages 10D
2

8 9
2.1 Example Message for Event Types O01 2 0
2E
2.1.1 Format Example
B 1
6 -
MSH|^~\&||EXT|EPIC||199402111015||ORM^O01|7||||PID|||19928377||JOHNSON^JOHN^^^^||19581023|M|JOHNSO
N^JOHN^^^^|W|121 W. MAIN STREET^APARTMENT 2^MADISON^WI^53703^||608-251-0000|608-271-9000||S|||111-
22-3333||||ORC|NW|332955|||||||19940211|||1022^CURMAN^MICHAEL^J^^^||||
A
OBR|1|332955||5923^HEMATOCRIT BLOOD COUNT|||||||||This is referral preparation standard
E
text.||BLD&BLOOD^^^LA&LEFT
- A
ARM|1022^CURMAN^MICHAEL^J^^^|||||||||||^^^^^R|99^CURMAN^MICHAEL^^^^~44^EPIC^MARY^^^^DG1|1|I9|001.9

2D
^CHOLERA NOS^I9|CHOLERA NOS||A|OBX|1|ST|WORKREL^Is injury/illness work related?||Yes

4A
0-
5E
- F
F F
5 1
C 1
59
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Supported Segments and Fields 10D
3

8 9
Shaded fields in the table are not used by this interface.
2 0
3.1 BHS Batch Header 2 E
B 1
This segment is used when receiving orders in a batch.
Element Name Type Usage Notes 6 -
1-Batch Field Separator ST R
AE
Value is typically: |
2-Batch Encoding Characters ST R
- A
Value is typically: ^~\&
3-Batch Sending Application ST O
2D
4-Batch Sending Facility ST O
4A
5-Batch Receiving Application ST O
0-
6-Batch Receiving Facility ST O
5E
7-Batch Creation Date/time
- DTM
F
O Format: Standard HL7 date/time format
8-Security
F F ST O
9-Batch Name/ID/Type
5 1 CM R
10-Batch Comment

C 1 ST R
11-Batch Control ID

59 ID R

D :
12-Reference Batch Control ID ID R

I
3.2 MSH Message Header
U
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Element Name Type Usage Notes

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Element Name Type Usage Notes
1 0D
1-Field Separator ST R Value is typically: |
8 9
2-Encoding Characters ST R Value is typically: ^~\&
2 0
3-Sending Application HD O Format: Free text
2 E
4-Sending Facility HD O Format: Free text

B 1
5-Receiving Application HD O
-
Format: Free text
6
6-Receiving Facility
7-Date/Time of Message
HD
DTM
O
O
AE
Format: Free text
Format: Standard HL7 date/time format
8-Security ST O
- A
9-Message Type CM R
2D
Format: <Message type>^<Trigger event>

A
Example: ORM^O01
4
10-Message Control ID ST R
0- Value returned in Acknowledgment message (MSA)

5E Format: Free text

11-Processing ID PT
F
R Format: Code

F F- Values:
D Debugging

5 1 P Production

C 1 T Training

12-Version ID
59 VID R HL7 version number

D : Example: 2.3
13-Sequence Number
U I NM O Optional field used in the sequence number protocol. By default Epic
does not use sequence number protocol.

c U Format: Numeric

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Element Name Type Usage Notes
1 0D
14-Continuation Pointer ST O
9
In conjunction with the HL7 DSC segment, this field is used to define
8
2 0
continuations of messages. It allows large messages to be broken into
multiple smaller messages, which is necessary under certain
implementation limitations.
2 E
information.
B 1
Consult HL7 chapter 2 and your Epic EDI representative for more

15-Accept Acknowledgment Type ID O

6 -
This field identifies the conditions under which Accept

AE
Acknowledgments are required to be returned in response to this
message. Required for enhanced acknowledgment mode. If null,

- A
acknowledgments are sent in original acknowledgment mode.

2D
Values:
AL Always

4A
ER Error/reject conditions only

0- NE Never

5E SU Successful completion only

F
16-Application Acknowledgment Type
17-Country Code
F
ID
ID F- O
O

5 1
1
3.3 PID Patient Identification
C
Element Name
59 Type Usage Notes
1-Set ID PID
D : SI O

U I
2-Patient ID
3-Patient Identifier List
CX
CX
O
R
This field is for backward compatibility only.
Format: <Patient ID>^^^<SA>^<assigning authority>

ic U The patient identifier list can contain values for the Social Security

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Element Name Type Usage Notes
1 0D
Security number>^^^USSSA^SS<License
8 9
number or driver's license number, formatted as follows: <Social

number>^^^<State>^DL
2 0
4-Alternate Patient ID PID CX O
2 E
5-Patient Name XPN R

B 1
6-Mother's Maiden Name ST O
6 -
7-Date/Time of Birth
8-Sex
DTM
IS
O
O
AE
Only date of birth is supported. Used only for validation purposes.
This field is mapped using the 769-Std In: Gender translation table.
9-Patient Alias XPN O
- A
10-Race CWE O
2D
This field can be mapped using a translation table.
11-Patient Address XAD O
4A
12-County Code IS O
0- This field is for backward compatibility only. You are encouraged to

5E use the county component of the patient address in PID-11.

This field is mapped using a translation table.
F
13-Phone Number Home

F
XTN
F- O Format: [nnn](nnn)nnn-nnnn^<Telecommunication use
code>^<Telecommunication equipment type>^<E-mail

5 1 address>^<Country code>^<Area/city code>^<Local

number>^<Extension>^<Any text>^<Extension

C 1 prefix>^<Speed dial code>^<Unformatted telephone

number>
14-Phone Number Work
59 XTN O (nnn)nnn-nnnnx<extension>

D : or

U I ^^^^^<City/area code>^<Number>^<Extension>
or

c U #<text>

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Element Name Type Usage Notes
10D
15-Primary Language CWE O This field is mapped using a translation table.
8 9
Formats:
<Language> 2 0
<Language>^^^^^^^^
2 E
B 1
16-Marital Status
17-Religion
CWE
CWE
O
O 6 -
This field is mapped using a translation table.
This field is mapped using a translation table.
18-Patient Account Number CX O
AE
Configurable; Can be used to locate the visit to which the message

A
should be associated.
-
19-SSN Number Patient ST O
D
Used for validation. Numeric with or without dashes

2
Social Security number can also be received in PID-3.
20-Driver's License Number Patient DLN O
4A
21-Mother's Identifier CX O
0-
22-Ethnic Group CWE O
5E
F
F-
23-Birth Place XAD O
24-Multiple Birth Indicator
1F ID O
25-Birth Order
15 NM O
26-Citizenship

9 C CWE O
27-Veterans Military Status
28-Nationality : 5 CWE
CWE
O
O

ID
29-Patient Death Date and Time DTM O

U U
30-Patient Death Indicator ID O

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3.4 NTE Notes Following PID
1 0D
This optional segment is ignored since PID information is not filed.
8 9
Element Name Type Usage Notes
2 0
1-Set ID Notes and Comments SI O
2E
2-Source of Comment ID O
B 1
3-Comment FT O
6 -
3.5 PV1 Patient Visit
AE
- A
The visit number provides an alternative method for locating test orders when the Epic order number cannot be returned by the
external system.
Element Name Type Usage 2D
Notes

4A
1-Set ID PV1 SI O
0-
2-Patient Class IS O

5E
3-Assigned Patient Location
-
PL
F
O
4-Admission Type

F F IS O
5-Pre-admit Number

5 1 CX O
6-Prior Patient Location

C 1 PL O
7-Attending Doctor
8-Referring Doctor 59 XCN
XCN
O
O
9-Consulting Doctor
D : XCN O

U I
10-Hospital Service IS O

c U
11-Temporary Location PL O Format: <Unit>^<Room>

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Element Name Type Usage Notes
10D
12-Pre-admit Test Indicator IS O
8 9
13-Readmission Indicator IS O
2 0
14-Admit Source IS O
2E
15-Ambulatory Status IS O

B 1
16-VIP Indicator IS O
6 -
17-Admitting Doctor
18-Patient Type
XCN
IS
O
O
AE
19-Visit Number CX O
- A
Visit identifier for the external system.
20-Financial Class FC O
2D
21-Charge Price Indicator IS O
4A
22-Courtesy Code IS O
0-
23-Credit Rating IS O
5E
24-Contract Code
- IS
F
O
25-Contract Effective Date
F F DT O
26-Contract Amount
5 1 NM O
27-Contract Period
C 1 NM O
28-Interest Code
59 IS O
29-Transfer to Bad Debt Code

D : IS O

U I
30-Transfer to Bad Debt Date
31-Bad Debt Agency Code
DT
IS
O
O

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Element Name Type Usage Notes
10D
32-Bad Debt Transfer Amount NM O
8 9
33-Bad Debt Recovery Amount NM O
2 0
34-Delete Account Indicator IS O
2E
35-Delete Account Date DT O

B 1
36-Discharge Disposition IS O
6 -
37-Discharged to Location
38-Diet Type
CM
CWE
O
O
AE
39-Servicing Facility IS O
- A
40-Bed Status IS O
2D
41-Account Status IS O
4A
42-Pending Location PL O
0-
43-Prior Temporary Location PL O
5E
44-Admit Date/Time
- DTM
F
O
45-Discharge Date/Time
F F DTM O
46-Current Patient Balance
5 1 NM O
47-Total Charges
C 1 NM O
48-Total Adjustments
59 NM O
49-Total Payments

D : NM O

U
51-Visit Indicator
I
50-Alternate Visit ID CX
IS
O
O

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Element Name Type Usage Notes
1 0D
52-Other Healthcare Provider XCN O
8 9
3.6 ORC Order Common 2 0
2 E
Most of the information on the optional ORC segment is ignored by the Incoming Clinical Lab Orders Interface. Note that most of the

B 1
information sent in this segment is also duplicated in the OBR segment. For ORM and OMG messages, the ORC segment is required.
Element Name Type Usage Notes
6 -
1-Order Control ID R E
Note: This field is used to flag specific events for the order, and is
A
required for ORM messages.

- A
Supported Codes:

D
OC - Order Canceled
2
A
CA - Cancel Order Request
4
0- NW - New Order

5E NA - Number Assignment

- F XO - Order Update

2-Placer Order Number

F F EI O External system order number

5 1 Format: String
3-Filler Order Number

C 1 EI O
4-Placer Group Number

59 EI O
5-Order Status
6-Response Flag
D : ID
ID
O
O

U
7-Quantity/Timing I TQ O

c U
8-Parent CM O

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Element Name Type Usage Notes
1 0D
9-Date/Time of Transaction DTM O
8 9
10-Entered By XCN O User ID of order creator
2 0
Audit trail Canceling user

2 E
Format: <User ID>^<Last name>^<First name>^<Middle
initial>
B 1
11-Verified By XCN O
6 -
12-Ordering Provider
13-Enterer's Location
XCN
PL
O
O AE
14-Call Back Phone Number XTN O - A
15-Order Effective Date/Time DTM O
2D
16-Order Control Code Reason CWE O
4A
Reason for cancellation

0- Format: <Mapped value>^<Full text for reason>

17-Ordering Organization CWE O
5E
F
F-
18-Entering Device CWE O External ID of the ordering workstation
Format: <External Ordering Workstation ID>^<Ordering Workstation

1F Name>
19-Action By
15 XCN O

3.7 OBR Observation Reports 9 C

: 5
The OBR segment is used to send information specific to each test order.
Element Name ID Type Usage Notes

U U
1-Set ID Observation Request SI R Sequentially numbered for each order; the interface can optionally

ic ignore missing Set ID values since some systems do not send

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Element Name Type Usage Notes
1 0D
them.Numeric
8 9
2-Placer Order Number EI R External system order number
Note: This field is required on all messages. 2 0
3-Filler Order Number Epic accession number.
2 E
B 1
Note: If received, this number must match the number stored on the
order.
6 -
4-Universal Service ID (test code) CWE R
E
Test code and name

A
Format: <External test ID>^<Test name>^<Name of coding
system>
- A
5-Priority ID O
D
This information is now sent in field 27.
2
6-Requested Date/Time DTM O

4A
7-Observation Date/Time DTM O
0- Collection date and time
8-Observation End Date/Time DTM O

5E
9-Collection Volume
-
CQ
F
O
10-Collector Identifier

F F XCN O
11-Specimen Action Code

5 1 ID O
12-Danger Code
13-Relevant Clinical Info
C 1 CWE
ST
O
O
14-Specimen Received Date/Time
59 DTM O
15-Specimen Source
D : CM O Specimen source (Body site)

U I Specimen source comment

c U Specimen type (Type of matter)

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Element Name Type Usage Notes
1 0D
8 9
Notes: The Specimen Type generally contains entries regarding the
type of matter collected, e.g., blood or urine, while Specimen Source

2 0
indicates the body site from which the matter was collected, e.g.,

2 E
mouth, wound, surgical site. Some lab systems do not differentiate
between the two, so the lab system may send only one of the two, or
both with the same value.
B 1
6 -
Default Format: <Type abbreviation>&<Type
title>^^^<Source abbreviation> &<Source

AE
title>^^<source comment>
Example: BLD&BLOOD^^^RA&RIGHT ARM^^Inside Elbow

- A
Alternative format: <Source>

D
Example: RIGHT ARM
2
16-Ordering Provider XCN O
A
Formats:
4
0- <ID>^^^^^^^^<Assigning authority>^^^^<ID type>
<ID number>^<Last name>^<First name>^<Middle

5E initial>^...

F
F-
17-Order Callback Phone Number XTN O
18-Placer Field 1
1F ST O Custom code can be written to process the data received in this field,
otherwise this field is not processed.

15 Format: Free text

19-Placer Field 2
9 C ST O Custom code can be written to process the data received in this field,

: 5 otherwise this field is not processed.

Format: Free text
20-Filler Field 1 ID ST O

U U
21-Filler Field 2 ST O

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Element Name Type Usage Notes
10D
22-Results Rpt/Status Change DTM O
8 9
Date/Time
23-Charge to Practice CM O 2 0
24-Diagnostic Serv Sect ID ID O
2 E
25-Result Status ID R
B 1
26-Parent Result CM O
6 -
27-Timing/Quantity TQ O
AE
If repeated values are sent, only the first value is used.

- A
Format: <Quantity>^<Frequency>^^<Start date and time>^<End date
and time>^<Priority>^^<Text>^^^^<Total occurrences>
28-Result Copies To XCN O
2D
Formats:

A
<ID>^^^^^^^^<Assigning authority>^^^^<ID
4
0- type>~<ID>^^^^^^^^<Assigning authority>^^^^<ID
type>~...

5E <ID>^<Name>~<ID>^<Name>~...

F
F-
29-Parent Number CM O
30-Transportation Mode
1F ID O
31-Reason for Study
15 CWE O
32-Principal Result Interpreter

9 C CM O
33-Assistant Result Interpreter
34-Technician : 5 CM
CM
O
O

I
35-TranscriptionistD CM O

U U
36-Scheduled Date/Time DTM O

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Element Name Type Usage Notes
1 0D
37-Number of Sample Containers NM O
8 9
38-Transport Logistics of Collected
Specimen
CWE O
2 0
39-Collector's Comment CWE O
2 E
40-Transport Arrangement CWE O
B 1
Responsibility
6 -
41-Transport Arranged ID O
AE
42-Escort Required ID O
- A
43-Planned Patient Transport Comment
44-Procedure Code
CWE
CNE
O
O 2D
45-Procedure Code Modifier CNE O
4A
This field contains the procedure code modifier to the procedure code

0- reported in field 4, when applicable. Procedure code modifiers are

5E defined by regulatory agencies such as HCFA and the AMA. Multiple

modifiers can be reported.
F
F-
Format: <ID>^<Name>~<ID>^<Name>~...

3.8 NTE Notes Following OBR 1F

15
These optional segments contain test-level comments related to the preceding OBR segment.
Element Name
9 C Type Usage Notes
1-Set ID Notes and Comments
: 5 SI O

I
2-Source of CommentD ID O
3-Comment
U U FT R Free text, typically order comments or scheduling instructions.

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Element Name Type Usage Notes
10D
4-Comment Type ST O
8 9
3.9 DG1 Diagnosis 2 0
2
This optional segment contains a diagnosis that will be associated with the test in the previous OBR segment and with the E
corresponding patient encounter.
B 1
Element Name Type Usage Notes
6 -
2-Diagnosis Coding Method ID O E
Value: <Code set> or <Null>, depending on configuration
A
3-Diagnosis Code DG1 CWE R
A
Format: <Diagnosis code>^<Description>^<Code set>
-
3.10 OBX Observation 2D
4A
It is expected that any OBX segments received will be associated with an order-specific question.
Element Name Type Usage
0- Notes
1-Set ID SI R
5E Note: Sequentially numbered for each OBX segment

F
F-
Format: Numeric
2-Value Type

1F ID R Supported Types:
ST String data

15 TX Text

9 C NM Numeric

: 5 DT - Date

3-Observation ID
ID CWE R Question ID

U U
4-Observation Sub-ID ST O

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Element Name Type Usage Notes
10D
5-Observation Value O Answer
8 9
Format: Defined by field 2 above

2 0
6-Units CWE O

2E
7-References Range ST O

B 1
8-Abnormal Flags
9-Probability
ID
NM
O
O 6 -
10-Nature of Abnormal Test ID O
AE
11-Observation Result Status ID O
- A
12-Date Last Observed Normal Values DTM O
2D
13-User Defined Access Checks ST O
4A
14-Date/Time of the Observation DTM O
0-
15-Producer's ID CWE O
5E Ordering system

- F Format: <Code>^<Text>
16-Responsible Observer

F F XCN O
17-Observation Method

5 1 CWE O
18-Equipment Instance Identifier

C 1 EI O

3.11 NTE Notes Following OBX

59
:
These optional segments contain question-level comments related to the preceding OBX segment.
D
Element Name
U I Type Usage Notes

ic U
1-Set ID Notes and Comments SI O

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Incoming Orders from CPOE Systems Interface Technical Specification 21
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Element Name Type Usage Notes
1 0D
2-Source of Comment ID O
8 9
3-Comment FT R Question-level comments
2 0
Format: Free text

2 E
3.12 ZRQ - Custom REQ Master File Item
B 1
Element Name Type Usage Notes
6 -
1-Set ID NM R
AE
Similar to OBR and OBX segment set IDs.
3-Content Identifier CD R
A
This value must correspond to a keyelement in general table R AIF 323
-
- CLINLAB ZRQ TABLE.
5-Content
2D
4A
3.13 BTS Batch Trailer
0-
Element Name Type E
Usage
5 Notes

F
F-
1-Batch Message Count ST O
2-Batch Comment

1F ST O
3-Batch Totals

15 CM O

9 C
: 5
ID
U U
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Incoming Orders from CPOE Systems Interface Technical Specification 22

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 1
2015 - 2016 Epic Systems Corporation. All rights reserved. PROPRIETARY INFORMATION - This item and its contents may not be accessed, used, modified, reproduced, released, performed,
0D
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1
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Care Elsewhere, Care Everywhere, Charge Router, Chronicles, Clarity, Cogito ergo sum, Cohort, Colleague, Comfort, Community Connect, Country Connect, Cupid, Epic, EpicCare, EpicCare Link,

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Epicenter, Epic Earth, EpicLink, EpicOnHand, EpicWeb, Good Better Best, Grand Central, Haiku, Healthy People, Healthy Planet, Hyperspace, Identity, IntraConnect, Kaleidoscope, Light Mode, Lucy,
MyChart, MyEpic, OpTime, OutReach, Patients Like Mine, Phoenix, Powered by Epic, Prelude, Radar, RedAlert, Region Connect, Resolute, Revenue Guardian, Rover, SmartForms, Sonnet, Stork,
Tapestry, Trove, Trusted Partners, Welcome, Willow, Wisdom, With the Patient at Heart and World Connect are registered trademarks, trademarks or service marks of Epic Systems Corporation

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in the United States and/or in other countries. Other product or company names referenced herein may be trademarks of their respective owners. U.S. and international patents issued and pending.

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