HL7 Pathology Laboratory Order Result

Implementation guideline HL7 version 2.
Order and result messages for pathology

information systems
PATHOLOGY, LABORATORY
Date
August 22, 2013
ID
13022
Author
Heitmann Consulting and Services – Dr. K.U. Heitmann
Reviewers
Nictiz – Drs. T. van Stijn
Nictiz – Drs. C.E. Hülsmann
www.nictiz.nl
Index
H-1 Introduction 4
1.1. Original author 4
1.2. Revision 4
1.3. Review 4
1.4. Translation 4
1.5. Status 4
1.6. Document history 5
H-2 Exchange format and workflow overview 6
2.1. Version of the HL7 protocol 6
2.2. Workflow overview 6
H-3 Order to the pathology laboratory 8
3.1. Process 8
3.2. Specification of message composition (segments) 8
3.3. MSH segment 9
3.4. PID segment 9
3.5. PV1 segment 15
3.6. ORC segment 16
3.7. OBR segment 18
3.8. SAC segment 20
3.9. OBX segment 20
H-4 Order confirmation of receipt 26
4.1. Variant 1 26
4.2. Variant 2 26
4.3. Variant 3 26
4.4. MSA segment 27
4.5. SAC segment 27
August 22, 2013 | Order and result messages for pathology information systems
H-5 Pathology laboratory results 32
5.1. Specification of message composition (segments) 32
5.2. MSH segment 32
5.3. PID segment 33
5.4. PV1 segment 35
5.5. ORC segment 35
5.6. OBR segment 35
5.7. OBX segment 38
H-6 Confirmation of receiving result message 41
H-7 Appendix I 42
7.1. Communication 42
7.2. MLLP 42
7.3. U-DPS attributes concerning the HL7 connection 42
H-8 Appendix II 43
8.1. Concepts 43
August 22, 2013 | Order and result messages for pathology information systems
H-1 Introduction
This document describes the HL7 version 2.4 messages used to order a study to be executed on tissue, cellular
material or an autopsy on a non-living person. An order message is sent to the pathology laboratory. In addition,
this document describes the result messages as a response to the described order messages.
The document is based on earlier versions of two documents by Tieto Healthcare Netherlands BV:
[1] “Documentatie koppelingen U-DPS – ZIS: HL7 ORU koppeling versie 2.4”, document version 1.0, 24
December 2008 and
[2] “Documentatie HL7 koppelingen: ORM koppeling versie NL 2.4”, document version 1.1.1, 24
November 2010
These documents as well as the current document are based on the following document that is owned bij the
HL7 Netherlands Foundation:
“Implementatie Gids HL7 Versie 2.4 NL” (Implementation guideline HL7 version 2.4 NL)
In that document, the following chapters have mainly served as a source for the present document:
[3] Chapter 2: Control
[4] Chapter 3: Patient Administration
[5] Chapter 4: Order Entry
[6] Chapter 7: Observation Reporting
1.1. Original author

Fons Geerts, Tieto Healthcare Netherlands BV
1.2. Revision
Dr. K.U. Heitmann (Heitmann Consulting and Services)
1.3. Review
Drs. T. van Stijn (Nictiz)
Drs. C.E. Hülsman (Nictiz)
1.4. Translation
This document has been translated from Dutch into English by Drs. C.E. Hülsmann. The purpose of translation is
serving all software vendors that operate nationally and or internationally, developing software for the Dutch
market.
1.5. Status
Final
August 22, 2013 | Order and result messages for pathology information systems 4
1.6. Document history
Version Date (ymd) Description Author
1.0 2008-12-24 Original document title: “HL7 ORU koppeling Fons Geerts
versie 2.4 [1]”
1.1.1 2010-11-24 Original document title: “ORM koppeling versie Fons Geerts
NL 2.4 [2]”
2.0 2012-04-12 Revision and merge of the first two ducuments, Dr. K. Heitmann
changes to version 2.4 and new message
types/trigger events
2.1 2012-04-20 Addition of report number and sample number Dr. K. Heitmann
in the confirmation message and making LOINC
codes compulsory where possible.
2.2 2012-04-25 Addition to Specimen Source, adjustments Dr. K. Heitmann

made because of incoming comments
2.3 2012-04-29 More comments and clarifications from earlier Dr. K. Heitmann
versions, reporting protocol and ACK messages
elaborated, correction of typing mistakes
2.4 2012-05-04 Correction of typing mistake OML event Dr. K. Heitmann
2.5 2012-08-01 Several changes after review by NICTIZ, mainly Dr. A. Huisman
of semantic or syntactic nature (MedicalPHIT for RIVM)
2.6 2012-11-11 Change of message type name ORU; addition Dr. K. Heitmann
of OBR-31 Reason for study
2.7 2012-11-28 Adjustment of Abstract Syntax Message for Dr. K. Heitmann

messages (addition of symbols)
2.8 2013-02-08 Document review and lay-out change Drs. C.E. Hülsmann
2.9 2013-02-13 Addition of the SAC segment in OMLÔ21 after Dr. K. Heitmann
receiving vendor feedback February 8th 2013
3.0 2013-06-06 Additional code for ‘Reason for study’, revision Dr. K. Heitmann
of the SAC segment, additional code for OBX-3
(additional note on material), examples
3.1 2013-06-30 Translation from Dutch into English, adjustment Drs. C.E. Hülsmann
of note PID-3, update of par. 3.1: use of BSN is
compulsory
H-2 Exchange format and workflow overview
2.1. Version of the HL7 protocol

U-DPS uses the HL7 protocol version 2.4 NL.
The BSN is the Dutch national identification number called ‘Burgerservicenummer’, also used in the healthcare
sector to identify a person. Whether or not this BSN has to be delivered to the receiving oranizations, depends on
the urge of the representatives of these organizations. In most cases, these organizations are Hospitals, the
receiver of the messages being the Hospital Information System (HIS).
The HL7 Netherlands Foundation has served as the main advisor for the specifications in this document. However,
this foundation does not own any specific guidelines on the composition of an order message for a pathology
laboratory. For this reason, this document emphasizes the use of the OBX segment as part of the message as far
as the ‘Kind of material’ and ‘Clinical information’ is concerned.
2.2. Workflow overview

Diagram 1 is an overview of all involved actors (application roles) and the HL7 v2.4 messages that are involved.
Diagram 1: Interactions between a lab order placer (original order initiator) and lab order filler (original order
executor, in this case the pathology laboratory)
A requesting system (order placer) sends requests for studies (orders) on tissue, cellular material or an autopsy on
a non-living person to the pathology laboratory (order filler) by sending a Lab Order Message OMLÔ21 (Message
Type OML, Trigger event O21).
After receiving the request, the pathology laboratory can reply by sending a Lab Order Response ORLÔ22
(asynchronous).
The pathology laboratory can send the study result using an Unsolicited Laboratory Observation Message
ORU^R01. In order to confirm the receipt of the study results, the order placer then sends an acknowledgement
message (ACK^R01) (synchronous).
In the following chapters the composition of the mentioned messages will be further elaborated as well as the
segments that are used in this document.
Note: The Lab Order Message OMLÔ21 is a new message since version 2.4 and replaces
the old ORM message. It is merely the same as the OMG message with some extensions.
H-3 Order to the pathology laboratory
In order to support the requests for study of tissue, cellular material or executing an autopsy on a non-living
person that are sent to the pathology laboratory, U-DPS supports a system for electronic ordering. This system is
using the HL7 protocol. From now on in this document the U-DPS system is mentioned when referring to the
system that receives the order (order filler), where this can also be another information system at the pathology
department.
3.1. Process
The order placer, e.g. an HIS, sends an order and U-DPS confirms receiving the order by sending a return
message. The laboratory can already inform the order placer about the study report number and the sample
number in this return message. However, in this stage informing the order placer about these numbers is
optional.
The study is executed at the pathology laboratory, and after that, when closing it, the order placer is informed
about the study results and the order number.
Placing the order is done by an authorized healthcare provider (HCP) and has to be interpreted as an official
order to perform a study. The code and name of the requesting HCP are used in the pathology study report.
Also, the order message is a source for patient information concerning his name and address, a description of
the material type and clinical information, that is available in the study result report.
Use of the BSN in digital communication in healthcare is compulsory. For this reason, using the 2.4 version of this
protocol is a necessity.
3.2. Specification of message compostion (segments)

The Lab Order Message OMLÔ21 uses the following HL7 v2.4 segments:
Segment Description
MSH Message header
PID Patient identification
PV1 Patient visit
{
ORC Order communication
[
OBR Observation Request
[ { SAC } ] Specimen Container Details
[ { OBX } ] Observation/Result
]
}
(Legend: Abstract Message Syntax, [ ] optional, { } one or more recurrences)
3.3. MSH segment
Table 1: HL7 Attribute Table - MSH - Message Header
SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME U-DPS

1 1 ST R 00001 Field Separator |
2 4 ST R 00002 Encoding Characters ^~&
3 180 HD O 0361 00003 Sending Application Contents agreed on by
all parties concerned
4 180 HD O 0362 00004 Sending Facility Contents agreed on by
5 180 HD O 0361 00005 Receiving Application Contents agreed on by
6 180 HD O 0362 00006 Receiving Facility Contents agreed on by
7 26 TS R 00007 Date/Time Of Message Format:
YYYYMMDDhhmmss
8 40 ST O 00008 Security Not used
9 13 CM R 0076/ 00009 Message Type OMLÔ21
0003  note MSH9
10 20 ST R 00010 Message Control ID
11 3 PT R 00011 Processing ID P
12 60 VID R 0104 00012 Version ID 2.4
13 15 NM O 00013 Sequence Number
14 180 ST O 00014 Continuation Pointer
15 2 ID O 0155 00015 Accept Acknowledgment Not used
Type
16 2 ID O 0155 00016 Application Acknowledgment Not used
Type
17 3 ID O 0399 00017 Country Code Not used
18 16 ID O Y 0211 00692 Character Set Not used
19 250 CE O 00693 Principal Language Of Not used
Message
20 20 ID O 0356 01317 Alternate Character Set Not used
Handling Scheme
21 10 ID O Y 0449 01598 Conformance Statement ID Not used
Note MSH9:
Element 9 in the MSH segment (Message type), in short MSH-9, has the following value:
OMLÔ21. In the response message Lab Order Response ORLÔ22 (see chapter H-5 in this
document) the value is: ORLÔ22. And so on.
3.4. PID segment
Table 2: HL7 Attribute Table – PID – Patient identification
SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME U-DPS

1 4 SI O 00104 Set ID - PID Not used
2 20 CX B 00105 Patient ID Not used
3 250 CX R Y 00106 Patient Identifier List Patient number
 note PID3
4 20 CX B Y 00107 Alternate Patient ID - PID Not used
5 250 XPN R Y 00108 Patient Name Patient name
 note PID5
6 250 XPN O Y 00109 Mother’s Maiden Name Not used
7 26 TS O 00110 Date/Time of Birth Date of birth
8 1 IS O 0001 00111 Administrative Sex Gender
9 250 XPN B Y 00112 Patient Alias Not used
10 250 CE O Y 0005 00113 Race Not used
11 250 XAD O Y 00114 Patient Address Patient address
information
 note PID11
12 4 IS B 0289 00115 County Code Not used
13 250 XTN O Y 00116 Phone Number - Home Not used
14 250 XTN O Y 00117 Phone Number - Business Not used
15 250 CE O 0296 00118 Primary Language Not used
16 250 CE O 0002 00119 Marital Status Not used
17 250 CE O 0006 00120 Religion Not used
18 250 CX O 00121 Patient Account Number Not used
19 16 ST B 00122 SSN Number - Patient Not used
20 25 DLN O 00123 Driver's License Number - Not used
Patient
21 250 CX O Y 00124 Mother's Identifier Not used
22 250 CE O Y 0189 00125 Ethnic Group Not used
23 250 ST O 00126 Birth Place Not used
24 1 ID O 0136 00127 Multiple Birth Indicator Not used
25 2 NM O 00128 Birth Order Not used
26 250 CE O Y 0171 00129 Citizenship Not used
27 250 CE O 0172 00130 Veterans Military Status Not used
28 250 CE B 0212 00739 Nationality Not used
29 26 TS O 00740 Patient Death Date and Time Not used
30 1 ID O 0136 00741 Patient Death Indicator Not used
31 1 ID O 0136 01535 Identity Unknown Indicator Not used
32 20 IS O Y 0445 01536 Identity Reliability Code Not used
33 26 TS O 01537 Last Update Date/Time Not used
34 40 HD O 01538 Last Update Facility Not used
35 250 CE C 0446 01539 Species Code Not used
36 250 CE C 0447 01540 Breed Code Not used
37 80 ST O 01541 Strain Not used
38 250 CE O 2 0429 01542 Production Class Code Not used
Note PID3: Patient identifier list (PID-3)

Only the ADT message HL7 v2.4 has the possibility to include the BSN, in a recurring PID-03
(sub-)segment, e.g.:
PID|1||43123456^^^LOCAL^PI ~055123456^^^NLMINBIZA^NNNLD||Onwel^Jolanda||....||
The first sub sub segment is the local patient number, the second is the BSN.
Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit
scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code
(ID)> ^ < assigning facility (HD) ^ <effective date (DT)> ^ <expiration date
(DT)>
Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID
(ST)> & <universal ID type (ID)>
Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)>
& <universal ID type (ID)>
Examples
BSN
066123456^^^NLMINBIZA^NNNLD^^20090101
Official identity document (passport/identity card)
AA1234567^^^NLMINBIZA^PPN^^20080101
Driver’s license
1234567890^^^NLRDW^DL^^20090107
Immigration document
12345678^^^NLIND^CZ^^20090701
When using the BSN and the official identity document, stating the date of verification can be
necessary.
The effective date component can be used to do so. Attention: The formal meaning of
effective date is the starting date of the identifier, meaning that from that moment on the
identifier is valid. In this case the component effective date is given a different meaning.
Table 3: User-defined Table 0363 - Assigning Authority
Code Description Dutch application

NLMINBIZA NL – Ministerie van Binnenlandse Zaken Burgerservicenummer (BSN)
(Ministry of Internal Affairs) Reisdocument (paspoort/identiteitskaart)
(BSN, passport/official identity
document)
NLMINJUS NL – Ministerie van Justitie
(Ministry of Justice)
NLVWS NL – Ministerie van Volksgezondheid, Welzijn en Sport
(Ministry of Health, Wellbeing and Sports)
NLIND NL – Immigratie en Naturalisatie Dienst Vreemdelingendocument
(Immigration Services) (Immigration document)
NLRDW NL – Rijksdienst voor het Wegverkeer Rijbewijs
(National road traffic service) (Driver’s license)
CIBG NL – Centraal Informatiepunt Beroepen Gezondheidszorg Zorgverlener Identificatienummer – UZI
(Dutch Central Information office for Healthcare professions) (Unique Healthcare Provider
Identification number)
Prismant NL – Onder andere voor de Landelijke Medische Registratie (LMR)
(a.o. for national medical registration)
Vektis NL – Centrum voor informatie en standaardisatie voor de
zorgverzekeraars
(Centre for information and standardization for healthcare
insurance companies)
LOCAL Lokaal gedefinieerd
(Locally defined)
<AGB code> AGB code van de instelling die het patiëntnummer heeft uitgereikt Compulsory in case of exchange of
(AGB code of the organization that issued the patient number) healthcare information across institution
borders
Table 4: HL7 Table 0203 - Identifier type
Code Description Dutch application

AM American Express
AN Account number DBC identification number
BA Bank Account Number To be used for a giro or bank account
number. The concerned bank has to be
mentioned in the field ‘Assigning Authority’.
Attention: this was ‘BANK’ and ‘GIRO’ in IG
2.3.
BR Birth registry number
BRN Breed Registry Number
CZ Citizenship Card Immigration document as meant by the
Dutch identification law ‘WID’ (Wet op de
identificatieplicht)
DI Diner’s Club card
DL Driver’s license number e.g. concerning the Dutch identification law
WID (‘Wet op de identificatieplicht’)
DN Doctor number
DR Donor Registration Number The Dutch ‘Donorregistratienummer’ is
meant.
DS Discover Card
EI Employee number
EN Employer number
FI Facility ID
GI Guarantor internal identifier
GN Guarantor external identifier
HC Health Card Number The Dutch ‘Zorgpasnummer’ is meant.
JHN Jurisdictional health number (Canada)
LN License number
LR Local Registry ID
MA Medicaid number
MC Medicare number
MCN Microchip Number
MR Medical record number Dutch ‘Medisch dossiernummer’ is meant
MS MasterCard
NE National employer identifier
NH National Health Plan Identifier
NI National unique individual identifier
NNNLD National Person Identifier where the xxx is the ISO table 3166 BSN
3-character (alphabetic) country code NNNLD
NPI National provider identifier The Dutch UZI number
PEN Pension Number
PI Patient internal identifier Patient number within the organization
PN Person number
PPN Passport number Passport number, but also in general an
official identity document (e.g. in accordance
with the Dutch identification law WID: ‘Wet
op de identificatieplicht’
PRN Provider number
PT Patient external identifier To be used for e.g. regional patient number,
or the patient number in another healthcare
institution.
RR Railroad Retirement number
RRI Regional registry ID
SL State license
SR State registry ID
SS Social Security number
U Unspecified
UPIN Medicare/HCFA’s Universal Physician Identification numbers
VN Visit number
VS VISA
WC WIC identifier
WCN Workers’ Comp Number
XX Organization identifier
Note PID5:
Components: In Version 2.3, replaces the PN data type. <family name (FN)> ^
<given name (ST)> ^ <second and further given names or initials
thereof (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g.,
DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <name type code (ID) > ^
<name representation code (ID)> ^ <name context (CE)> ^ <name
validity range (DR)> ^ <name assembly order (ID)>
U-DPS: < second and further given names or initials thereof> contains the Dutch ‘voorletters’
(initials)
Subcomponents of family name: <surname (ST)> & <own surname prefix (ST)> &
<own surname (ST)> & <surname prefix from partner/spouse (ST)> &
<surname from partner/spouse (ST)>
U-DPS:
naamvrouw = <own surname>
naamman (echtgenoot van) = <surname from partner/spouse>
In HL7 version 2.3 the field PID-9 ‘Patient alias’ was still used to communicate several
different parts of the name. In this version however, the datatype XPN is extensive enough to
communicate all parts of the Legal name.
Note PID11:
Components: In Version 2.3 and later, replaces the AD data type. <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)> ^ <address
representation code (ID)> ^ <address validity range (DR)>
Subcomponents of street address: <street address (ST)> & <street name (ST)> &
<dwelling number (ST)>
This field contains all the patient’s addresses. The first address in this field has to be the
address that is used to correspond with the patient.
The field is filled as specified in Table 5. U-DPS does not use all the data in this element.
Table 5: HL7 Adress Type componenten en sub-componenten
Component Sub component Usage in The Netherlands

Street address As of version 2.4 ‘street address’ is a complex datatype. Different parts of the
address can be filled in into the various sub components.
Street address Street name and dwelling number should be in this field as a composition, for
reasons of backwards compatibility.
Street name ‘Straatnaam’
Dwelling number ‘Huisnummer’, some implementations are known where dwelling number and
street name are combined in the field Street name.
Other designation ‘Huisnummertoevoeging’, additional information to specify the precise
dwelling.
City ‘Woonplaats’
State N.A.
Zip or postal code ‘Postcode’, in case of a Dutch postal code no spaces should be entered: e.g.
2316XA
Country Country in which the specified address is.
Address type The first address should have the value ‘M’ (mailing). Other addresses can be
specified, e.g. home address (‘H’), or temporary address or residence (‘C’).
Other geographic N.A.
designation
County/parish code N.A.
Census tract N.A.
Address repre- N.A.
sentation code
Address validity Starting date and end date of validity of the address can be specified using
range this field. This could be of use for temporary addresses.
Date range start Starting date of validity of the address
date/time
Date range end Last moment in time when the address is still valid (valid up to and including).
date/time
Examples:
PID|||0112159^^^^PI~203444906^^^^NNNLD||Reubsaet-
Geurts&""&Geurts&""&ReubsaetÂ^^^^^L||19151201|F|||Aelserhof 1^Êlsloo Lb^^6181 LB^NL||046-
4378238 P||N||||||||||||||""|N
PID|||1234567^^^^PI~122298222^^^^NNNLD||Broek van der – Gruiter de&de&Gruiter&van

der&Broek^L.^^^^^L||19200101|V|||Postweg
14&Postweg&14^^Tilburg^^5000KL^^M^^^^^20080220&20080420~Logeerstraat
34&Logeerstraat&34^^Best^^7800YY^^C^^^^^20080220&20080227||040- 1234567||||||||||||||||||N|
3.5. PV1 segment
Table 6: HL7 Attribute Table - PV1 – Patient visit

1 4 SI O 00131 Set ID - PV1 Not used
2 1 IS R 0004 00132 Patient Class Indication meaning inpatient
or outpatient
 values: see Table 7
3 80 PL O 00133 Assigned Patient Department
Location
4 2 IS O 0007 00134 Admission Type
5 250 CX O 00135 Preadmit Number
6 80 PL O 00136 Prior Patient Location
7 250 XCN O Y 0010 00137 Attending Doctor
8 250 XCN O Y 0010 00138 Referring Doctor
9 250 XCN B Y 0010 00139 Consulting Doctor
10 3 IS O 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 Re-admission Indicator
14 6 CWE O 0023 00144 Admit Source
15 2 IS O Y 0009 00145 Ambulatory Status
16 2 IS O 0099 00146 VIP Indicator
17 250 XCN O Y 0010 00147 Admitting Doctor
18 2 IS O 0018 00148 Patient Type
19 250 CX O 00149 Visit Number Case of illness, in case this is
used by the HIS (SAP)
20 50 FC O Y 0064 00150 Financial Class Financial Class
21 2 IS O 0032 00151 Charge Price Indicator Charge Price Indicator
22 2 IS O 0045 00152 Courtesy Code Courtesy Code
23 2 IS O 0046 00153 Credit Rating Credit Rating
24 2 IS O Y 0044 00154 Contract Code Contract Code
25 8 DT O Y 00155 Contract Effective Date Contract Effective Date
26 12 NM O Y 00156 Contract Amount Contract Amount
27 3 NM O Y 00157 Contract Period Contract Period
28 2 IS O 0073 00158 Interest Code Interest Code
29 1 IS O 0110 00159 Transfer to Bad Debt Transfer to Bad Debt Code
Code
30 8 DT O 00160 Transfer to Bad Debt Transfer to Bad Debt Date
Date
31 10 IS O 0021 00161 Bad Debt Agency Code Bad Debt Agency Code
32 12 NM O 00162 Bad Debt Transfer Bad Debt Transfer Amount
Amount
33 12 NM O 00163 Bad Debt Recovery Bad Debt Recovery Amount
Amount
34 1 IS O 0111 00164 Delete Account Indicator Delete Account Indicator
35 8 DT O 00165 Delete Account Date Delete Account Date
36 3 IS O 0112 00166 Discharge Disposition Discharge Disposition
37 25 CM O 0113 00167 Discharged to Location Discharged to Location
38 250 CE O 0114 00168 Diet Type Diet Type
39 2 IS O 0115 00169 Servicing Facility Servicing Facility
40 1 IS B 0116 00170 Bed Status Bed Status
41 2 IS O 0117 00171 Account Status Account Status
42 80 PL O 00172 Pending Location Pending Location
43 80 PL O 00173 Prior Temporary Prior Temporary Location
Location
44 26 TS O 00174 Admit Date/Time Admit Date/Time
45 26 TS O Y 00175 Discharge Date/Time Discharge Date/Time
46 12 NM O 00176 Current Patient Balance Current Patient Balance
47 12 NM O 00177 Total Charges Total Charges
48 12 NM O 00178 Total Adjustments Total Adjustments
49 12 NM O 00179 Total Payments Total Payments
50 250 CX O 0203 00180 Alternate Visit ID Alternate Visit ID
51 1 IS O 0326 01226 Visit Indicator Visit Indicator
52 250 XCN B Y 0010 01274 Other Healthcare Other Healthcare Provider
Provider
Table 7: possible values for PV1-2
Code Beschrijving
I klinisch (inpatient)
O Poliklinisch
(outpatient)
P Preadmit
(Preadmit)
K MedKeuring
(medical test)
D Dag (day)
B PolBev
(Obstetrics)
3.6. ORC segment
Table 8: HL7 Attribute Table – ORC – Common Order

1 2 ID R N 0119 00215 Order Control Order status
 note ORC1
2 22 EI C 00216 Placer Order Number Placer order number, delivered
by the sending system
3 22 EI C 00217 Filler Order Number Filler order number, PA
number
 note ORC3
4 22 EI O 00218 Placer Group Number Not used
5 2 ID O N 0038 00219 Order Status Not used
6 1 ID O 0121 00220 Response Flag Not used
7 200 TQ O Y 00221 Quantity/Timing Used to specify the priority
 note ORC7
8 200 CM O 00222 Parent Not used
9 26 TS O 00223 Date/Time of Date/time when the order is
Transaction registered in the ordering
system.
 note ORC9
10 120 XCN O Y 00224 Entered By Not used
11 120 XCN O Y 00225 Verified By Not used
12 120 XCN O Y 00226 Ordering Provider Ordering Provider (coded)
 note ORC12
13 80 PL O 00227 Enterer’s Location Location (coded)
 note ORC13
14 250 XTN O Y/2 00228 Call Back Phone Not used
Number
15 26 TS O 00229 Order Effective Not used
Date/Time
16 250 CE O 00230 Order Control Code Not used
Reason
17 250 CE O 00231 Entering Organization Not used
18 250 CE O 00232 Entering Device Not used
19 120 XCN O Y 00233 Action By Not used
20 250 CE O 0339 01310 Advanced Beneficiary Not used
Notice Code
21 250 XON O Y 01311 Ordering Facility Name Not used
22 250 XAD O Y 01312 Ordering Facility Not used
Address
23 250 XTN O Y 01313 Ordering Facility Phone Not used
Number
24 250 XAD O Y 01314 Ordering Provider Not used
Address
25 250 CWE O N 01473 Order Status Modifier Not used
Note ORC1:
Of all available codes that can be delivered using this element, U-DPS uses the codes:
NW, CA and CR.
Table 9: possible values for ORC-1
Code Description
NW nieuwe order
(new order)
CA or CR verwijderen order
(cancel order)
Cancelling the order can currently only be indicated if the order has not yet been
incorporated into a report.
Note ORC3:
The filler order number (‘rapportnummer’) will be the unique laboratory order number
indicating the registered study. The used format is:
<type of study><year>–<serial number>
type of study can contain: B, C, S, T or M. Year: only the last two digits of the year in which
the material is received. Serial number: a pathology/anatomy (PA) number (unique for each
laboratory) and possibly a version indicator: A, B, C, D....
Examples:
T09-00001 Histologie
C09-00001 Cytologie
S09-00001 Obductie
B09-00001 Cervixcytologie
This study report number is only issued when the received order is being processed. This can
be at the moment of confirming the order (when processing the order starts), or later, when
the report after performing the study is finished.
Note ORC7:
ORC-7 sub field 6 can contain a character that may cause the priority of the study to be risen.
In other words: should the study be performed in emergency, or should it not.
U-DPS reacts on the character ‘S’. Caused by this ‘S’, the field ‘soortaanvraag’ (kind of order)
will contain the value ‘spoed’ (emergency). All other values lead to a normal priority:
‘normaal’.
The information is also part of the OBR-27 sub field 6.
Note ORC9:
Date-time on which the order is entered into the ordering system of the ordering application.
Should this field be empty, then the date of de MSH segment can be used as a source.
Note ORC12:
The ordering provider number that is delivered by the HIS, is converted into an order placer
code in U-DPS. When a result is issued, the ordering provider number as known in the HIS will
be provided by U-DPS.
Note ORC13:
In case registering a location code is a necessity, the code will be incorporated into the U-DPS
report.
3.7. OBR segment
Table 10: HL7 Attribute Table – OBR – Observation Request

1 4 SI O 00237 Set ID - OBR Not used
2 22 EI C 00216 Placer Order Number Placer order number,
delivered by the sending
system
3 22 EI C 00217 Filler Order Number + Filler order number, PA
number
4 250 CE R 00238 Universal Service ID Type of study
 note OBR4
5 2 ID B 00239 Priority - OBR Not used
6 26 TS B 00240 Requested Date/Time Not used
7 26 TS C 00241 Observation Date/Time # Not used
8 26 TS O 00242 Observation End Not used
Date/Time #
9 20 CQ O 00243 Collection Volume * Not used
10 60 XCN O Y 00244 Collector Identifier * Not used
11 1 ID O 0065 00245 Specimen Action Code * Not used
12 250 CE O 00246 Danger Code Not used
13 300 ST O 00247 Relevant Clinical Info. Not used
14 26 TS C 00248 Specimen Received Not used
Date/Time *
15 300 CM O 0070 00249 Specimen Source * Not used
0163
0369
16 120 XCN O Y 00226 Ordering Provider See ORC segment
17 250 XTN O Y/2 00250 Order Callback Phone Not used
Number
18 60 ST O 00251 Placer Field 1 Not used
20 60 ST O 00253 Filler Field 1 + Not used
22 26 TS C 00255 Results Rpt/Status Chng Not used
- Date/Time +
23 40 CM O 00256 Charge to Practice + Not used
24 10 ID O 0074 00257 Diagnostic Serv Sect ID Hospital/institution
optional: location of
requestor (coded)
25 1 ID C 0123 00258 Result Status + Not used
26 200 CM O 00259 Parent Result + Not used
27 200 TQ O Y 00221 Quantity/Timing Not used
28 150 XCN O Y/5 00260 Result Copies To Receivers of copies of the
result report
(code and name to be filled
in)
30 20 ID O 0124 00262 Transportation Mode Not used
31 250 CE O Y 00263 Reason for Study  note OBR31
32 200 CM O 00264 Principal Result Not used
Interpreter +
33 200 CM O Y 00265 Assistant Result Not used
Interpreter +
34 200 CM O Y 00266 Technician + Not used
35 200 CM O Y 00267 Transcriptionist + Not used
36 26 TS O 00268 Scheduled Date/Time + Not used
37 4 NM O 01028 Number of Sample Not used
Containers *
38 250 CE O Y 01029 Transport Logistics of Not used
Collected Sample *
39 250 CE O Y 01030 Collector’s Comment * Not used
40 250 CE O 01031 Transport Arrangement Not used
Responsibility
41 30 ID O 0224 01032 Transport Arranged Not used
42 1 ID O 0225 01033 Escort Required Not used
43 250 CE O Y 01034 Planned Patient Not used
Transport Comment
44 250 CE O 0088 00393 Procedure Code Not used
45 250 CE O Y 0340 01316 Procedure Code Modifier Not used
46 250 CE O Y 0411 01474 Placer Supplemental Not used

Service Information
47 250 CE O Y 0411 01475 Filler Supplemental Not used
Service Information
Note OBR4:
The sending system can use this field for terms like one of the following:
Histologie (Histology)
Cytologie (Cytology)
Obductie (Autopsy)
Cervixcytologie (Cervixcytology)
In practice, the pathology department will often decide by itself on the study to be
performed.
Note OBR31:
The reason for study (request) can be specified here. This is optional. For now only one of
the following values is permitted:
BVO-DDK (bowel cancer screening)
BVO-DDK-NOTP (bowel cancer screening, only for study, it is not permitted to
redistribute the information to third parties, e.g. ColonIS)
3.8. SAC segment

SAC segment specification see paragraph 4.5.
3.9. OBX segment
Table 11: HL7 Attribute Table – OBX – Observation

1 4 SI O 00569 Set ID - OBX Serial number of the
OBX segment
2 2 ID C 0125 00570 Value Type FT
3 250 CE R 00571 Observation Identifier  note OBX3
4 20 ST C 00572 Observation Sub-ID Not used
5 65536 * C Y 00573 Observation Value  note OBX5
6 250 CE O 00574 Units Not used
7 60 ST O 00575 References Range Not used
8 5 IS O Y/5 0078 00576 Abnormal Flags Not used
9 5 NM O 00577 Probability Not used
10 2 ID O Y 0080 00578 Nature of Abnormal Test Not used
11 1 ID R 0085 00579 Observation Result Status Not used
12 26 TS O 00580 Date Last Observation Not used
Normal Value
13 20 ST O 00581 User Defined Access Not used
Checks
14 26 TS O 00582 Date/Time of the Not used
Observation
15 250 CE O 00583 Producer's ID Not used
16 250 XCN O Y 00584 Responsible Observer Not used
17 250 CE O Y 00936 Observation Method Not used
18 22 EI O Y 01479 Equipment Instance Not used

Identifier
19 26 TS O 01480 Date/Time of the Analysis Not used
The clinical data is available as normal text in U-DPS. For this reason, it speaks for itself to use the OBX segment
in the order message for this information exchange. The OBX segment can provide big chunks of formatted text,
that can be processed by U-DPS.
Note OBX3:
One or more OBX segment will be used in the OBX-3 field. U-DPS is expecting the
information as specified in Table 12.
Table 12: possible values for OBX-3
Code U-DPS rubriek (section) Permitted values
KLINGEG klinische gegevens, vrije tekst

(clinical data, free text)
VRAAG klinische vraagstelling, vrije tekst
(clinical request, free text)
MAT aard materiaal, afgestemd op de inhoud van de
keuzelijst: “aard materiaal” in U-DPS
(kind of material, in harmony with the contents
of the list of choices called ‘aard materiaal’ (kind
of material) in U-DPS)
MATTOE aanvullende opmerkingen op het materiaal
(additional notes about the material)
TOESTEMMING Toestemmingcipa, de toestemming om uitslagen ja (yes)
door te sturen naar de landelijke PALGA beperkt (restricted)
databank (die voorheen cipa heette)
wetenschap (research)
(Permission ‘cipa’ to send the results to the
national PALGA data bank, formerly called ‘cipa’) nee (no)
RESTMATERIAAL Restmateriaal ja (yes)
(Rest material) nee (no)
lokaal (local)
vernietigen (destroy)
verkrijgingswijze For this, the SAC
(method used to acquire the substance) segment SAC-6 is used,
see par. 4.5
Een term die begint met CR_ cris3 cervixcytologie See also the note below
(a term starting with CR_) (cris3 cervixcytology)
Een andere term die niet in (could be used as an indicatior for a code)
dit rijtje voorkomt
(A different term, not stated
in this list)
Note OBX5:
OBX-5 is used for text belonging to the concerned identifier. The amount of text is almost
unlimited, which makes this element very suitable for communicating study requests and
their corresponding results as to be performed by pathology laboratories.
Tissue and cell studies
The clinical information for these types of research is stated in free text. The types of
study distinguished in pathology are: histology, cytology and autopsy. The material kind is
restricted. U-DPS uses a choice list called ‘aardmateriaal’ (kind of material).
The information provided by the HIS need to meet the information that is available in the
following list:
OBX-3 = ‘MAT’ indicates to U-DPS that the concerned information is kind of
material.
OBX-3 = ‘VERKRIJGING’: the method used to acquire the substance is stated in
SAC-6, see the SAC segment in par. 4.5.
OBX-3 = ‘KLINGEG’ and ‘VRAAG’ are indicators for other clinical data. Information
is acquired from the sections ‘klinische gegevens’ (clinical data) and ‘klinische
vraagstelling’ (clinical question) respectively.
Cervixcytology protocol CRIS3
Should the code indicate a value that has been determined as part of the protocol, then a
numeric code is sufficient.
Should the code indicate free text, then a restiction of 24 positions needs to be regarded.
Apart from the coded clinical data as part of the CRIS3 protocol, it is possible to extend
the clinical information with free text.
OBX-3 ‘KLINGEG’ and ‘VRAAG’ are an indication for this extended clinical information
being present. Information is acquired from the sections ‘klinische gegevens’ and
‘klinische vraagstelling’ respectively.
One or more OBX segments will be used. U-DPS expects the information in the OBX-3 field
as specified in Table 12. Should the code begin with CR_, then values as stated in Table 13
are expected.
Note: all codes are defined ‘locally’. This means that they have to contain ‘L’ (see
examples) as namespace identifier.
Table 13: possible values for CR_ terms in OBX-3
CR_ term values allowed format/

clarification
CR_DATUMSTRIJK dd-mm-yy
CR_AANLEIDING 1 BVO 1. (bowel screening
2 BVO-herh. (wegens onbeoordeelbaarheid) 2. bowel screening
3 (gyn.) klacht/sympt. recurrence, because of
diffculties of evaluation
4 vervolgonderzoek
3. Gynaecological
5 DES-dochter
complaint/symptom
6 op verzoek vrouw
4. Further examination
9 anders: (vrije tekst maximaal 24 tekens).
5. DES daughter
6. On women’s request
9. Other: (free text, max.
24 characters) )
CR_DOOR 1 Huisarts 1. (General Practitioner
2 Gynaecoloog 2. Gynaecolgist
3 Assistent(e) 3. Assistant
9 anders: (vrije tekst maximaal 24 tekens). 9. Other: (free text, max.
24 characters) )
CR_INSTRUMENT 1 cervexbrush 1. (Cervexbrush

2 cytobrush en spatel 2. Cytobrush and spatula
3 spatel 3. Spatula
4 dunne laag 4. Thin layer
24 characters) )
CR_KLACHTEN 0 geen 0. (None
1 abnormaal bloedverlies 1. Abnormal blood loss
2 contactbloedingen 2. Contact bleedings
24 characters) )
CR_DATUMLM dd-mm-yy
CR_PATROON 0 geen 0 (none

1 regelmatig 1 regular
2 onregelmatig 2 irregular
3 menopauze 3 menopause
4 postmenopauze 4 post menopauze
9 anders: (vrije tekst maximaal 24 tekens). 9 other: (free text, max.
X onbekend 24 characters)
X unknown)
CR_ANTICONCEPTIE 0 geen 0 (none
1 hormonaal 1 hormonal
2 IUD 2 IUD
9 other: (free text, max.
9 anders: (vrije tekst maximaal 24 tekens). 24 characters)
X onbekend X unknown)
CR_HORMOONGEBRUIK 0 geen 0 (none
1 > (vrije tekst; naam preparaat maximaal 24 1 > (free text; name
tekens). supplement max. 24
X onbekend characters)
X unknown)
CR_OPMERKING 0 geen 0 (no remark
1 wel: (vrije tekst, maximaal 24 tekens). 1 remark: (free text; name
supplement max. 24
characters) )
CR_INGREPEN 0 geen 0 (none
1 cryo-, coagulatie- of laserbehandeling 1 cryo, coagulation or
2 conisatie, lisexcisie, biopt laser treatment
3 supravaginale uterusextirpatie 2 conisation, lisexcision,
biopsy
5 radiotherapie
3 supravaginal uterus
6 combinatie, nl: > (vrije tekst, maximaal 24
extirpation
tekens).
5 radiotherapy
9 anders: > (vrije tekst, maximaal 24 tekens).
6 combination, namely: >
X onbekend
(free text; name supplement
N n.v.t max. 24 characters)
9 other: (free text, max.
24 characters)
X unknown
N N.A.)
CR_ASPECT 1 normaal 1 (normal
2 niet gezien 2 not seen
3 abnormale/verdachte portio 3 abnormal/suspicious
N n.v.t portio
N N.A.)
CR_ZWANGERSCHAP 0 geen 0 (none
1 zwangerschap 1 pregnancy
2 post partum 2 post partum
3 lactatie 3 lactation
4 postlactatie 4 post lactation
5 geen lactatie 5 no lactation
X onbekend X unknown
N n.v.t N N.A.)
CR_DUUR number in weeks
CR_BVOREGNR For the purpose of cervical cancer screening. This mainly concerns requests for
screening studies by gynaecologists. The screening registration number is issued
by the screening organization sending the calls for screening. This is a 14-digit
number, the first four digits correspond to the screening organization.
General example fragment

OBX|1|FT|MAT^^L||darm||||||F
OBX|2|FT|KLINGEG^^L||This is the space for free text concerning clinical
information.\.br\Next line ||||||F
OBX|3|FT|VRAAG^^L||Maligniteit ?||||||F
Example fragment specifically for cervix cytology

OBX|1|FT|CR_DATUMSTRIJK^^L||01-01-07||||||F
OBX|2|FT|CR_AANLEIDING^^L||1||||||F
OBX|3|FT|CR_DOOR^^L||1||||||F
OBX|4|FT|CR_INSTRUMENT^^L||1|||||F
OBX|5|FT|CR_KLACHTEN^^L||9 erosie|||||F
OBX|6|FT|CR_DATUMLM^^L||01-01-07|||||F
OBX|7|FT|CR_PATROON^^L|||||||F
OBX|8|FT|CR_ANTICONCEPTIE^^L||0|||||F
OBX|9|FT|CR_HORMOONGEBRUIK^^L||0|||||F
OBX|10|FT|CR_OPMERKINGEN^^L||1 free text|||||F
OBX|11|FT|CR_INGREPEN^^L||0|||||F
OBX|12|FT|CR_ASPECT^^L||1|||||F
OBX|13|FT|CR_ZWANGERSCHAP^^L||1|||||F
OBX|14|FT|CR_DUUR^^L||20|||||F
OBX|15|FT|KLINGEG^^L||Extra clinical information |||||F
Example fragment specifically for polyp coecum

OBX|10|FT|MAT^^L||coecum||||||O
OBX|11|FT|VRAAG^^L||Maligniteit?||||||O
OBX|12|FT|VERKRIJGING^^L||biopteur||||||O
OBX|13|FT|MATTOE^^L||Poliep 1: Afgebeeld coecum 5 mm gesteeld (Paris classif. 0-1p) Adenocarcinoom
Kudo 1 resectietechniek; niet radicaal; potje I||||||O
H-4 Order confirmation of receipt
After receiving the order request, the pathology laboratory responds using the Lab Order Response ORLÔ22.
The confirmation of receipt as specified in this document contains the following HL7 v2.4 segments:
Segment Beschrijving
MSH Message header
MSA Message acknowledgement
[ (beginning of optional group)
PID Patient Identification
{ (beginning of group, recurring if necessary)
ORC Common Order
OBR Observation Request
[ { SAC } ] Specimen Container Details (optional, recurring if necessary)
} (end of group, recurring if necessary)
] (end of optional group)
Basically there are three variants of the confirmation message, depending on what has to be communicated to
the other party.
4.1. Variant 1
The confirmation message sent by U-DPS, containing an MSH (see above) and an MSA segment. This is the most
simple way to send a confirmation message.
4.2. Variant 2
In case of having to send the segments as mentioned in Variant 1, including a report number, the optional group
containing the PID, ORC and OBR is used. The report number can be found in the ORC-3 element (filler order
number, see the specification of the ORC segment par. 3.6).
Note that also the PID segment containing the patient data and the OBR segment containing the request data
have to be added.
4.3. Variant 3
The SAC segment (can be recurring) can be used to communicate a sample number, should the sample numbers
also need to be added to the message.
4.4. MSA segment
Table 14: HL7 Attribute Table - MSA - Message Acknowledgment

1 2 ID R 0008 00018 Acknowledgment Code AA = correct
AE = incorrect
2 20 ST R 00010 Message Control ID
3 80 ST O 00020 Text Message
4 15 NM O 00021 Expected Sequence Number
5 1 ID B 0102 00022 Delayed Acknowledgment
Type
6 250 CE O 0357 00023 Error Condition
4.5. SAC segment
Table 15: HL7 Attribute Table - SAC - Specimen and container detail segment

1 80 EI O 0008 01329 External Accession Identifier  note SAC1
2 80 EI O 01339 Accession Identifier Not used
3 80 EI C 01331 Container Identifier  note SAC3
4 80 EI C 01332 Primary (parent) Container Not used
Identifier
5 80 EI O 01333 Equipment Container Not used
Identifier
6 300 SPS O 0070 00249 Specimen Source  note SAC6
… (rest van het segment) Not used
Note SAC1:
This identifier contains (if the segment is present) the sample number, in the way it has been
issued (in advance) by the order placer. The identifier can also contain identifying sample
characteristics (e.g. Roman digits to indicate a jar number)
Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^
<universal ID (ST)> ^ <universal ID type (ID)>
Examples:
SAC|4551236ÔLP
SAC|45639.2.323-IV^MDLS
Note SAC3:
This identifier contains the sample number as issued by the laboratory.
Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^
<universal ID (ST)> ^ <universal ID type (ID)>
Example:
SAC|||2232102^LMS
Note SAC6:
A value of the HL7 table 0070 (specimen source) needs to be used here.
Components: <specimen source name or code (CE)> ^ <additives (TX)> ^
<free text (TX)> ^ <body site (CE)> ^ <site modifier (CE)> ^
<collection method modifier code (CE)> ^ <specimen role (CE)>
Example:
SAC|||2232102^LMS|||ASP
Table 16: possible values for Specimen Source (HL7 table 0070)
Code Description
ABS Abscess
AMN Amniotic fluid
ASP Aspirate
BBL Blood bag
BDY Whole body
BIFL Bile fluid
BLD Whole blood
BLDA Blood arterial
BLDC Blood capillary
BLDCO Cord blood
BLDV Blood venous
BON Bone
BPH Basophils
BPU Blood product unit
BRN Burn
BRO Bronchial
BRTH Breath (use EXHLD)
CALC Calculus (=Stone)
CBLD Cord blood
CDM Cardiac muscle
CNJT Conjunctiva
CNL Cannula
COL Colostrum
CSF Cerebral spinal fluid
CTP Catheter tip
CUR Curettage
CVM Cervical mucus
CVX Cervix
CYST Cyst
DIAF Dialysis fluid
DOSE Dose med or substance
DRN Drain
DUFL Duodenal fluid
EAR Ear
EARW Ear wax (cerumen)
ELT Electrode
ENDC Endocardium
ENDM Endometrium
EOS Eosinophils
EXG Exhaled gas (=breath)
EXHLD Exhaled gas (=breath)
EYE Eye
FIB Fibroblasts
FIST Fistula
FLT Filter
FLU Body fluid, unsp
GAS Gas
GAST Gastric fluid/contents
GEN Genital
GENC Genital cervix
GENL Genital lochia
GENV Genital vaginal
HAR Hair
IHG Inhaled Gas
ISLT Isolate
IT Intubation tube
LAM Lamella
LIQ Liquid NOS
LN Line
LNA Line arterial
LNV Line venous
LYM Lymphocytes
MAC Macrophages
MAR Marrow
MBLD Menstrual blood
MEC Meconium
MILK Breast milk
MLK Milk
NAIL Nail
NOS Nose (nasal passage)
ORH Other
PAFL Pancreatic fluid
PAT Patiënt
PLAS Plasma
PLB Plasma bag
PLC Placenta
PLR Pleural fluid (thoracentesis fld)
PMN Polymorphonuclear neutrophils
PPP Platelet poor plasma
PRP Platelet rich plasma
PRT Peritoneal fluid /ascites
PUS Pus
RBC Erythrocytes
RT Route of medicine
SAL Saliva
SEM Seminal fluid
SER Serum
SKM Skeletal muscle
SKN Skin
SMN Seminal fluid
SNV Synovial fluid (Joint fluid)
SPRM Spermatozoa
SPT Sputum
SPTC Sputum - coughed
SPTT Sputum - tracheal aspirate
STL Stool = Fecal
STON Stone (use CALC)
SWT Sweat
TEAR Tears
THRB Thrombocyte (platelet)
THRT Throat
TISG Tissue gall bladder
TISPL Tissue placenta
TISS Tissue
TISU Tissue ulcer
TLGI Tissue large intestine
TLNG Tissue lung
TSMI Tissue small intestine
TUB Tube NOS
ULC Ulcer
UMB Umbilical blood
UMED Unknown medicine
UR Urine
URC Urine clean catch
URNS Urine sediment
URT Urine catheter
URTH Urethra
USUB Unknown substance
VITF Vitreous Fluid
VOM Vomitus
WAT Water
WBC Leukocytes
WICK Wick
WND Wound
WNDA Wound abscess
WNDD Wound drainage
WNDE Wound exudate
H-5 Pathology laboratory results
The pathology laboratory result is sent as an Unsolicited Laboratory Observation Message ORU^R01. In case of
U-DPS, the concerned studies are performed by a pathology laboratory.
U-DPS initiates sending the messages. In order to do so, a script will be started regularly to determine if any
authorized reports are available to be provided.
5.1. Specification of message composition (segments)

The Unsolicited Laboratory Observation Message ORU^R01 uses the following HL7 v2.4 segments:
Segment Description
MSH Message header
PID Patient identification
[ PV1 ] Patient visit (optional)
[ ORC ] Order communication (optional)
OBR Observation Report ID
{ [ OBX ] } Observation Results
The original requestor, in this case the receiving system (order placer), receives the Unsolicited Laboratory
Observation Message ORU^R01, and replies with an acknowledgment message containing the following
segments:
Segment Description
MSH Message header
MSA Message acknowledgment
5.2. MSH segment
Table 17: HL7 Attribute Table - MSH - Message Header

1 1 ST R 00001 Field Separator |
2 4 ST R 00002 Encoding Characters ^~&
3 180 HD O 0361 00003 Sending Application Contents agreed on by
4 180 HD O 0362 00004 Sending Facility Contents agreed on by
5 180 HD O 0361 00005 Receiving Application Contents agreed on by
6 180 HD O 0362 00006 Receiving Facility Contents agreed on by
7 26 TS R 00007 Date/Time Of Message Format:
YYYYMMDDhhmmss
8 40 ST O 00008 Security Not used
9 13 CM R 0076/ 00009 Message Type ORU^R01
0003
10 20 ST R 00010 Message Control ID DPS ID
11 3 PT R 00011 Processing ID P
12 60 VID R 0104 00012 Version ID 2.4
13 15 NM O 00013 Sequence Number
14 180 ST O 00014 Continuation Pointer
15 2 ID O 0155 00015 Accept Acknowledgment Not used
Type
16 2 ID O 0155 00016 Application Acknowledgment Not used
Type
17 3 ID O 0399 00017 Country Code Not used
18 16 ID O Y 0211 00692 Character Set Not used
19 250 CE O 00693 Principal Language Of Not used
Message
20 20 ID O 0356 01317 Alternate Character Set Not used
Handling Scheme
21 10 ID O Y 0449 01598 Conformance Statement ID Not used
5.3. PID segment
Tabel 18: HL7 Attribute Table – PID – Patient identification

1 4 SI O 00104 Set ID - PID Not used
2 20 CX B 00105 Patient ID Not used
3 250 CX R Y 00106 Patient Identifier List Patiëntnummer (Patient
number)
 note PID3
4 20 CX B Y 00107 Alternate Patient ID - PID Not used
5 250 XPN R Y 00108 Patient Name Naam patiënt
 note PIDP
6 250 XPN O Y 00109 Mother’s Maiden Name Not used
7 26 TS O 00110 Date/Time of Birth Geboortedatum
 note PIDP
8 1 IS O 0001 00111 Administrative Sex Geslacht
 note PIDP
9 250 XPN B Y 00112 Patient Alias Not used
10 250 CE O Y 0005 00113 Race Not used
11 250 XAD O Y 00114 Patient Address Not used
12 4 IS B 0289 00115 County Code Not used
13 250 XTN O Y 00116 Phone Number - Home Not used
14 250 XTN O Y 00117 Phone Number - Business Not used
15 250 CE O 0296 00118 Primary Language Not used
16 250 CE O 0002 00119 Marital Status Not used
17 250 CE O 0006 00120 Religion Not used
18 250 CX O 00121 Patient Account Number Not used
19 16 ST B 00122 SSN Number - Patient Not used
20 25 DLN O 00123 Driver's License Number - Not used
Patient
21 250 CX O Y 00124 Mother's Identifier Not used
22 250 CE O Y 0189 00125 Ethnic Group Not used
23 250 ST O 00126 Birth Place Not used
24 1 ID O 0136 00127 Multiple Birth Indicator Not used
25 2 NM O 00128 Birth Order Not used
26 250 CE O Y 0171 00129 Citizenship Not used
27 250 CE O 0172 00130 Veterans Military Status Not used
28 250 CE B 0212 00739 Nationality Not used
29 26 TS O 00740 Patient Death Date and Time Not used
30 1 ID O 0136 00741 Patient Death Indicator Not used
31 1 ID O 0136 01535 Identity Unknown Indicator Not used
32 20 IS O Y 0445 01536 Identity Reliability Code Not used
33 26 TS O 01537 Last Update Date/Time Not used
34 40 HD O 01538 Last Update Facility Not used
35 250 CE C 0446 01539 Species Code Not used
36 250 CE C 0447 01540 Breed Code Not used
37 80 ST O 01541 Strain Not used
38 250 CE O 2 0429 01542 Production Class Code Not used
Note PID3:
The element ‘Patient Identifier List’ will be used for providing the local patient number, but
also for patient numbers of other hospitals or institutions. This element is also used for the
BSN, in case this is available in the U-DPS report.
Note PIDP:
Although patient identification can be completely performed on the HIS side based on the
local patient number, some of the HIS representatives prefer to be provided with patient
data such as the name and/or date of birth and/or gender.
In agreement with each software vendor separately it has to be decided on which of these
elements will be delivered by the U-DPS.
5.4. PV1 segment
In the optional PV1 segment the only important element is PV1-19 ‘Visit number’ for some Hospital Information
Systems. In most cases this concerns the information that has to be provided concerning a specific health
problem number, the so-called ‘ziektegevalnummer’.
5.5. ORC segment

This is an optional segment and only of importance when order communication is also used.
5.6. OBR segment
Table 19: HL7 Attribute Table – OBR – Observation Request

1 4 SI O 00237 Set ID - OBR Volgnummer
(Sequence number)
2 22 EI C 00216 Placer Order Number  note OBR2
3 22 EI C 00217 Filler Order Number +  note OBR3
4 250 CE R 00238 Universal Service ID  note OBR4
5 2 ID B 00239 Priority - OBR Not used
6 26 TS B 00240 Requested Date/Time Not used
7 26 TS C 00241 Observation Date/Time # Datum van ontvangst
(reception date)
8 26 TS O 00242 Observation End Datum van verzending
Date/Time # (bij definitief verslag)
(Date when sent – in
case of final report)
9 20 CQ O 00243 Collection Volume * Not used
10 60 XCN O Y 00244 Collector Identifier * Not used
11 1 ID O 0065 00245 Specimen Action Code * Not used
12 250 CE O 00246 Danger Code Not used
13 300 ST O 00247 Relevant Clinical Info. Not used
14 26 TS C 00248 Specimen Received Not used
Date/Time *
15 300 CM O 0070 00249 Specimen Source * Aard materiaal
0163 (kind of material)
0369
16 120 XCN O Y 00226 Ordering Provider Aanvrager onderzoek
(gecodeerd)
 note OBR16
(Order filler code)
17 250 XTN O Y/2 00250 Order Callback Phone Not used
Number
22 26 TS C 00255 Results Rpt/Status Chng Not used
- Date/Time +
23 40 CM O 00256 Charge to Practice + Not used
24 10 ID O 0074 00257 Diagnostic Serv Sect ID Hoofdafdeling
 note OBR24
(Main department)
25 1 ID C 0123 00258 Result Status +  note OBR25
26 200 CM O 00259 Parent Result + Not used
27 200 TQ O Y 00221 Quantity/Timing Not used
28 150 XCN O Y/5 00260 Result Copies To ontvangers van kopieën
van het verslag van de
resultaten
 note OBR28
(Recepients of copies of
the results report)
30 20 ID O 0124 00262 Transportation Mode Not used
31 250 CE O Y 00263 Reason for Study Not used
32 200 CM O 00264 Principal Result  note OBRI
Interpreter +
33 200 CM O Y 00265 Assistant Result  note OBRI
Interpreter +
34 200 CM O Y 00266 Technician +  note OBRI
35 200 CM O Y 00267 Transcriptionist + Not used
36 26 TS O 00268 Scheduled Date/Time + Not used
37 4 NM O 01028 Number of Sample Not used
Containers *
38 250 CE O Y 01029 Transport Logistics of Not used
Collected Sample *
39 250 CE O Y 01030 Collector’s Comment * Not used
40 250 CE O 01031 Transport Arrangement Not used
Responsibility
41 30 ID O 0224 01032 Transport Arranged Not used
42 1 ID O 0225 01033 Escort Required Not used
43 250 CE O Y 01034 Planned Patient Not used
Transport Comment
44 250 CE O 0088 00393 Procedure Code Not used
45 250 CE O Y 0340 01316 Procedure Code Modifier Not used
46 250 CE O Y 0411 01474 Placer Supplemental Not used
Service Information
47 250 CE O Y 0411 01475 Filler Supplemental Not used
Service Information
Note OBR2:
This is the request identification (order number), issued by the application placing the order.
In the component namespace the code of this application is added. This field corresponds to
the field with the same name in the ORC-segment.
In U-DPS the contents of the field ‘ordernummer’ (order number) are mentioned, should they
be available.
Note OBR3:
This is the report number from the pathology department (unique reference to the report
containing the study results). Furthermore see note ORC3, par. 3.6.
Note OBR4:
this element contains the type of study. For pathology these are:
Histologie (Histology)
Cytologie (Cytology)
Obductie (Autopsy)
Cervixcytologie (Cervixcytology)
Note OBR16
The notation to use is ordering provider number or researcher, optionally completed with
the name:
<code>^<naam>
The ordering provider number corresponds with the number the HIS uses as a unique
identification of the healthcare professional in the hospital. This can also be a number for
a healthcare professional working in the primary care sector.
U-DPS has a field ‘codeaanvrager’ (‘requestor code´). The value of this field almost never
corresponds to the number the hospital uses. For this reason, the contents of the field
‘codeaanvrager’ from the order filler file of U-DPS is used to derive the ZIS code.
Note OBR24
At HIS vendor CSC the TH5-code is expected from the order filler (department).
Note OBR25
In almost all situations code ‘F’ meaning ‘final results’ is used.
When sending reports that are still under consideration (status: ‘in behandeling’), the code ‘I’
(large i) is used.
Note OBR28
OBR-28 is optional. It is used to add information about recipients of a copy of the report.
These recipients are registered in U-DPS using a code in the tab ‘Copie’ (Copy).
Note: The U-DPS contains a field ‘code(copie)’, but the value of this field nearly never
corresponds to the number the hospital uses. For this reason, the contents of the field
‘codeaanvrager’ from the order filler file of U-DPS is used to derive the ZIS code.
In most cases only the first two components are used (number and name).
Note OBRI
In most cases, when effectuating the results of the study, at least a pathologist is concerned.
Note: In a U-DPS report the pathologist is registered using a code. This is a local code, in most
cases not corresponding to the code that the pathologist is known in the hospital by. This
code will therefore be diverted using the local pathologist code in the report. For both the
pathologist resident and the analyst the same method applies.
5.7. OBX segment
Table 20: HL7 Attribute Table – OBX – Observation

1 4 SI O 00569 Set ID - OBX Serial number of the OBX
segment
2 2 ID C 0125 00570 Value Type FT
3 250 CE R 00571 Observation Identifier  note OBX3
4 20 ST C 00572 Observation Sub-ID Not used
5 65536 * C Y 00573 Observation Value Result study text
6 250 CE O 00574 Units Not used
7 60 ST O 00575 References Range Not used
8 5 IS O Y/5 0078 00576 Abnormal Flags Not used
9 5 NM O 00577 Probability Not used
10 2 ID O Y 0080 00578 Nature of Abnormal Test Not used
11 1 ID R 0085 00579 Observation Result Status  note OBR25
12 26 TS O 00580 Date Last Observation Not used
Normal Value
13 20 ST O 00581 User Defined Access Not used
Checks
14 26 TS O 00582 Date/Time of the Not used
Observation
15 250 CE O 00583 Producer's ID Not used
16 250 XCN O Y 00584 Responsible Observer Not used
17 250 CE O Y 00936 Observation Method Not used
18 22 EI O Y 01479 Equipment Instance Not used
Identifier
19 26 TS O 01480 Date/Time of the Analysis Not used
Note OBX3:
This code contains a description of the performed study.
Components: <identifier>^<text>^<name of coding system>^
<alternate identifier>^<alternate text>^<name of alternatecoding system>
Together with <name of coding system>, as a rule, L (for ‘local‘) will be used. An alternative
code can be added as well.
Other possible components are not used.
In Table 21 the values for ‘identifier‘ are specified.
Table 21: possible values for the identifier component for OBX-3
Pathology item Code LOINC description Namespace
Klinische gegevens 22636-5 Path Report.Relevant HX LN

(= tekst aanvraag onderzoek)
(Clinical information – text study
request)
Macroscopie 22634-0 Path. Report.gross observation LN
(Macroscopy)
Microscopie 22635-7 Path. Report microscopic LN
(Microscopy) observation
Epicrise 33746-9 Pathologic findings LN
(discharge summary)
Protocol 34122-2 Pathology procedure note LN
Conclusie 22034-3 Pathology report.total LN
(vh totale onderzoek)
Diagnosen 22637-3 Pathology report. Final diagnosis LN
(Diagnoses)
Aanvullend onderzoek (lokaal1) AANVUL (not LOINC, but own code) L
(additional study, local1)
Signalering (melding van externe SIGNALERING (not LOINC, but own code) L
complicaties)
(Signal – indication of external
complications)
Titel in overleg lokaal1, lokaal2, (not LOINC, but own code) L
(Title to be decided on in lokaal3
cooperation)
Examples:
OBX|1|FT|22634-0^^LN||Text belonging to macroscopy||||||F
OBX|2|FT|22635-7^^LN||Text belonging to macroscopy||||||F
...
OBX|5|FT|AANVUL^^L||Text additional study||||||F
Essentially, the message receiver has to convert the identifier into a human readable title. This should be agreed
upon.
Most of the studies are performed based on a set of guidelines and protocols. Also, registration of the study and
reporting the study itself can be predefined and registered separately and made available for information
exchange: protocol name, protocol data and reporting according to protocol. The protocols are added in the
OBX segment, using LOINC code 34122-2.
The generic format is as follows:
\.in+4\\.ti-4\protocoltag1: text1\.sp\\.ti-4\protocoltag2: text2\.sp\\.ti-4\ . . .
At the beginning of the text concerning the report according to protocol, the element \.in+4\ is added. After
that, for each line, the item \.ti-4\ follows, together with the protocol tag (protocoltag, e.g. ‘Protocolversie‘
meaning protocol version, or ‘Aantal poliepen‘ meaning number of polyps), followed by a ‘:‘ (colon) and the
corresponding report text (text). The line is closed using an \.sp\ . This way a report text can always contain a
syntax to indicate the tags and values, since the tag is always enclosed by a \.ti-4\ and a ‘:‘ (colon).
Example:
OBX|7|FT|34122-2^^LN||\.in+4\\.ti-4\Protocolnaam: Colon rectum
carcinoom\.sp\\.ti-4\Protocolversie: 7\.sp\\.ti-4\Protocollaire beschrijving: tekst\.sp\\.ti-
4\Aantal poliepen: 0 . . .||||||F
H-6 Confirmation of receiving result message
After receiving the result message from the pathology laboratory, the order placer confirms receiving the results
by sending an ACK^R01 message.
This message contains the following HL7 v2.4 segments:
Segment Description
MSH Message header
MSA Message acknowledgement
This message corresponds to a Lab Order Message OMLÔ21 with an MSH and an MSA segment. The MSH-9
element for an ACK^R01 message contains the value ‘ACK^R01’.
H-7 Appendix I
7.1. Communication
TCP/IP based on a socket connection is used for communication to and from an external information system.
The IP-address/server name and socket can be adjusted.
7.2. MLLP
In case of socket communication, using the so-called Minimum Lower Layer Protocol MLLP is preferred.
7.3. U-DPS attributes concerning the HL7 connection

The U-DPS has the following functionalities for receiving and processing the digital orders that are delivered to
U-DPS:
At port 9700 a server is listening continuously. Also, this server receives the messages that are
delivered.
Port 9700 is the port that is configured as the standard port in U-DPS. If needed, the value of this port
can be changed if agreed upon by the concerned parties.
Immediately after receiving an order, a message is sent to the order filler system, confirming the
reception.
The order is saved in U-DPS in a certain manner until it is incorporated into a study report.
When providing the study results, the order number is delivered as well.
H-8 Appendix II
8.1. Concepts
Concept Description
PALGA Foundation National Pathologic Anatomic Automated Archive, see http://www.palga.nl
(Stichting PALGA)
U-DPS Uniform Decentralized PALGA System. A system that is facilitated by PALGA for
reporting in pathology laboratories.

HL7 Pathology Laboratory Order Result

Hochgeladen von

Dokumentinformationen

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

HL7 Pathology Laboratory Order Result

Hochgeladen von

Copyright:

Verfügbare Formate

Implementation guideline HL7 version 2.

Order and result messages for pathology

1.1. Original author

Version Date (ymd) Description Author

2.2 2012-04-25 Addition to Specimen Source, adjustments Dr. K. Heitmann

2.4 2012-05-04 Correction of typing mistake OML event Dr. K. Heitmann

2.7 2012-11-28 Adjustment of Abstract Syntax Message for Dr. K. Heitmann

2.1. Version of the HL7 protocol

2.2. Workflow overview

3.2. Specification of message compostion (segments)

(Legend: Abstract Message Syntax, [ ] optional, { } one or more recurrences)

Table 1: HL7 Attribute Table - MSH - Message Header

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME U-DPS

3.4. PID segment

Table 2: HL7 Attribute Table – PID – Patient identification

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME U-DPS

Note PID3: Patient identifier list (PID-3)

Table 3: User-defined Table 0363 - Assigning Authority

Code Description Dutch application

Table 4: HL7 Table 0203 - Identifier type

Code Description Dutch application

Table 5: HL7 Adress Type componenten en sub-componenten

Component Sub component Usage in The Netherlands

PID|||1234567^^^^PI~122298222^^^^NNNLD||Broek van der – Gruiter de&de&Gruiter&van

3.5. PV1 segment

Table 6: HL7 Attribute Table - PV1 – Patient visit

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME U-DPS

Table 7: possible values for PV1-2

3.6. ORC segment

Table 8: HL7 Attribute Table – ORC – Common Order

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME U-DPS

3.7. OBR segment

Table 10: HL7 Attribute Table – OBR – Observation Request

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME U-DPS

46 250 CE O Y 0411 01474 Placer Supplemental Not used

3.8. SAC segment

3.9. OBX segment

Table 11: HL7 Attribute Table – OBX – Observation

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME U-DPS

18 22 EI O Y 01479 Equipment Instance Not used

Table 12: possible values for OBX-3

Code U-DPS rubriek (section) Permitted values

KLINGEG klinische gegevens, vrije tekst

RESTMATERIAAL Restmateriaal ja (yes)

CR_ term values allowed format/

CR_INSTRUMENT 1 cervexbrush 1. (Cervexbrush

CR_PATROON 0 geen 0 (none

General example fragment

Example fragment specifically for cervix cytology

Example fragment specifically for polyp coecum

Table 14: HL7 Attribute Table - MSA - Message Acknowledgment

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME U-DPS

4.5. SAC segment

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME U-DPS

5.1. Specification of message composition (segments)

5.2. MSH segment

Table 17: HL7 Attribute Table - MSH - Message Header

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME U-DPS

5.3. PID segment

Tabel 18: HL7 Attribute Table – PID – Patient identification

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME U-DPS

5.5. ORC segment

5.6. OBR segment