The function of this message is to initiate the transmission of information about an order. This includes placing new orders, cancellation of existing orders, discontinuation, holding, etc. ORM messages can originate also with a placer, filler, or an interested third party.
The trigger event for this message is any change to an order. Such changes include submission of new orders, cancellations, updates, patient and nonpatient specific orders, etc.
ORM General Order Message Chapter
MSH Message Header 2
[{NTE}] Notes and Comments (for Header) 2
[
PID Patient Identification 3
[PD1] Additional Patient Identification 3
[{NTE}] Notes and Comments (for Patient ID) 2
[PV1 Patient Visit 3
[PV2|] Patient Visit Additional Information 3
[{IN1 Insurance 6
[IN2] Insurance Additional Info 6
[IN3] Insurance Additional Info 6
}]
[GT1] Guarantor 6
[{AL1}] Allergy 3
]
]
{
ORC Common Order 4
[
Order Detail Segment OBR, etc. 4
[{NTE}] Notes and Comments (for Detail) 2
[{DG1}] Diagnosis 6
[
{
OBX Observation/Result 7
[{NTE}] Notes and Comments (for Results) 2
}
]
]
{[CTI]} Clinical Trial Identification 7
[BLG] Billing segment 4
}
a) The abstract message syntax for some order segments vary slightly. Please refer to the appropriate sections for specific examples: for supply orders (RQ), see Section 4.7, "SUPPLY ORDERS"; for pharmacy, see Section 4.8, "PHARMACY/TREATMENT ORDERS"; and for dietary orders, see Section 4.6, "DIET ORDERS."
b) The segment named "Order Detail Segment" represents whichever of these order detail segment(s) is appropriate to the message, currently OBR, RQD, RQ1, RXO, ODS, ODT.
c) The NTE segment(s) can be included in the ORM message in four places; in each place the NTE refers to the segment which it follows. In particular, the NTEs following the MSH refer only to the message header, the NTEs following the order detail segment apply to the service defined by that ORC and order detail segment.
d) The PID segment is required if and only if new orders are being entered and they are related to a particular patient. For nonpatient-related orders the PID segment is never included.
e) The optional PV1 segment is present mainly to permit transmission of patient visit information such as current location with an order.
f) The order detail segments are not required when a simple control message is being sent. For example, a hold message (ORC-1-order control = HD) does not require that an order segment follow it.
g) ORC-1-order control is critical to the operation of both ORM and ORR messages. For example, to request cancellation of an order, one would transmit a CA in ORC-1-order control of the appropriate ORC. (See the definition of ORC-1-order control.)
h) A method to inquire for order status in the display format is provided in Chapter 2, and uses the record format provided in Chapter 7.
i) Each order message that defines any type of new order (ORC-1-order control = NW, CH, RO or SN) requires an ORC/OBR pair to define each order to the receiving application. This also applies to any other types of orders, with the OBR being replaced by the appropriate order detail segment, as defined below. Thus two consecutive ORCs could occur if a cancel order request (needing only the order numbers) were followed by a second cancel order request. Many other examples are possible.
j) The insurance segments (IN1, IN2, and GT1) are typically used for external fillers, e.g., reference labs, where formal ADT transactions are overly complex or not needed.