The purpose of this section is to show how certain specific situations would be handled using the order entry protocol. The ellipses represent uncompleted details. The symbol // precedes comments for clarification.
Suppose that an application called "PC" is sending an order to the EKG application for three EKGs to be done on successive days.
The order might be placed as follows:
ORM message:
MSH|...
PID|...
ORC|NW|A226677^PC||946281^PC||N|3^QAM||198801121132|P123^AQITANE^ELLINORE^""^""^""^MD|||4EAST<CR>
// EKG order
OBR||||8601-7^EKG IMPRESSION^LN||||||||||||P030^SMITH^MARTIN^""^""^""^MD|||||||||||3^QAM<CR>
BLG|...
ORC||... // Another order yet others may follow
There is a group number first component indicating that an order group is being created.
Responses: Because the EKG application must turn the single order above into three orders for three separate EKGs (services), the results of each will be reported under its own OBR segment. Several response levels are possible depending on the Response Flag:
a) If the Response Flag is N (as it is), then the filler EKG application only responds "I got the order."
MSH|...
MSA|...
The only implication of this response is that the order was received.
If the Response Flag had been E, then the response would have been the same, but its implication would have been that the EKG application had processed all the orders and they were acceptable.
b) If the Response Flag were R, then the filler EKG application must communicate to the PC the fact of the creation of child orders, but with no details:
MSH|...
MSA|...
ORC|PA|A226677^PC|89-458^EKG|946281^PC<CR>
ORC|CH|A226677^PC|89-551^EKG|946281... // 1ST child ORC.
ORC|CH|A226677^PC|89-552^EKG|946281... // 2ND child ORC.
ORC|CH|A226677^PC|89-553^EKG|946281... // 3RD child ORC.
... // Other parts of response might follow.
What has been said here is "Your A226767 has spun out three children named 89-551, 89-552, and 89-553." Notice that the placer Numbers are identical in the childrens ORCs.
c) If the Response Flag were D, then the filler EKG application must communicate to the PC application the fact of the replacement and also the exact replacement order segments:
MSH|...
MSA|...
ORC|PA|A226677^PC|89-458^EKG<CR>
ORC|CH|A226677^PC|89-551^EKG|946281^PC|SC|||A226677&PC^89-458&EKG|
... ^^^^198901130500^<CR> // 1ST child ORC
OBR|||89-551^EKG|8601-7^EKG IMPRESSION^LN|... // 1ST child OBR
ORC|CH|A226677^PC|89-522^EKG|946281^PC|SC|||A226677&PC^89-458&EKG|
... ^^^^198901140500^<CR> // 2ND child ORC
OBR|||89-552^EKG|8601-7^EKG IMPRESSION^LN|... // 2ND child OBR
ORC|CH|A226677^PC|89-553^EKG|946281^PC|SC|||A226677&PC^89-458&EKG|
...^^^^198901150500^<CR> // 3RD child ORC
OBR|||89-553^EKG|8601-7^EKG IMPRESSION^LN|... // 3RD child OBR
// Other parts might follow
Here the actual OBR segments have been added.
The status of the child orders is being reported as SC (scheduled).
ORC-4-quantity/timing shows that the EKGs are requested after 0500 on successive days.