This chapter describes the messages used to generate orders. Specific transaction sets have been defined for orders: a) clinical observations and diagnostic studies, b) treatments, c) diets, d) supplies, and e) other orders. This chapter is organized accordingly. The first Sections, 4.1, "OVERVIEW," and 4.2, "ORDER MESSAGE DEFINTIONS," present the overall structure and rationale for these messages. Section 4.3 presents the message segments that are common to all of the order entry messages. Section 4.4, "QUANTITY/TIMING (TQ) DEFINITION," describes the quantity/timing (TQ) data type. Sections 4.5, "OBSERVATION AND DIAGNOSTIC STUDY ORDERS," to 4.8.7.26, "Give indication (CE) 01128 describe the messages for each of the major categories of orders listed above. Each section about a type of order is organized into background and overview, message structure, and message segments (that are specific to the order class in question). Special discussions of the use of fields, segments or messages, and examples are included.
Segments are introduced in order of occurrence in a message. A cross-reference list of segments to page numbers is included at the end of the chapter. A list of allowable values for a field is included in the body of the text, along with the field definition for easier reference.
Orders for laboratory tests, bedside monitoring, diagnostic imaging, electrocardiograms, vital signs, etc., are subsumed under the observation message set (see Section 4.5, "OBSERVATION AND DIAGNOSTIC STUDY ORDERS"). In the development of the treatment order transaction set (see Section 4.8, "PHARMACY/TREATMENT ORDERS"), the focus has been on medication treatments, but the same transaction set works well for total parenteral nutrition (TPN). There is hope that it is also sufficient for other kinds of treatment orders, such as those performed by the nursing service. But it has not yet been exercised in that context and may well need further development. The orders for dietary (see Section 4.6, "DIET ORDERS" ) include all of the usual diet specifications including snacks and guest trays. Supply orders (Section 4.7, "SUPPLY ORDERS") are different in that they often are not patient-centered (e.g., requests to stock the ward supply room).