The purpose of this section is to show how certain specific situations would be handled using the pharmacy/treatment protocol. The ellipses represent uncompleted details. The symbol // precedes comments for clarification.
The order give 500 mg Ampicillin P.O. Q6H for 10 days for a total of 40 tablets is sent to the RX application from the OE application. This order can be coded with various levels of precision by an ordering application:
a) E-mail only version (uses only free text, RXO-6-providers pharmacy/treatment instructions or RXO-7-provider's administration instructions only); fully encoded version must be re-entered or verified manually by the pharmacy or treatment application.
b) With RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and RXO-1-requested give code as free text.
c) With RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but where RXO-1-requested give code does not include units.
d) With RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and where RXO-1-requested give code does include units.
In this case, the units are optional. The rule for this case (on orders, dispense results, give results, and administration results) is as follows: if units are coded, they over-ride or supersede the units value implied by the give code.
a) The E-mail only version of the order: no coded fields exist in the RXO.
MSH|...
PID|...
ORC|NW|1000^OE||||E||||||||
RXO||||||500 mg Polycillin Q6H for 10 days, dispense 40 Tablets||
b) A partially coded version of the order. This version has the RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but the RXO-1-requested give code as free text.
MSH|...
PID|...
ORC|NW|1000^OE||||E|^Q6H^D10^^^R|||||||
RXO|^Polycillin 500 mg TAB^|500||MG|||||Y||40|
RXR|PO|
c) A more completely coded version of the order, with the RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but where RXO-1-requested give code does not imply units.
MSH|...
PID|...
ORC|NW|1000^OE||||E|^Q6H^D10^^^R|||||||
RXO|RX1001^Polycillin^L|500||MG|||||Y||40|
RXR|PO|
d) A completely encoded version, with the RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and where RXO-1-requested give code does imply units.
MSH|...
PID|...
ORC|NW|1000^OE||||E|^Q6H^D10^^^R|||||||
RXO|RX1001^Polycillin 500 mg TAB^L|500||MG|||||G||40|
RXR|PO|
e) Pharmacy or treatment suppliers encoded version (RDE message) sent to nursing application (a generic substitution).
MSH|...
PID|...
ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|||||||
RXE|^^^199012100600^^R|0047-0402-30^Ampicillin 250 MG TAB^NDC|2||TAB|||||G|80||||123456|rx#1001|
RXR|PO|
f) Pharmacy or treatment suppliers dispense results (RDS message).
MSH|...
PID|...
ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|||||||
RXD|1|0047-0402-30^Ampicillin 250 MG TAB^NDC|199012100400|8|TAB||RX#1001|||123456|G|8
g) Pharmacy or treatment suppliers give results (RGV message).
MSH|...
PID|...
ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|||||||
RXG|1|1|^^199012100600^^R|0047-0402-30^Ampicillin 250 MG TAB^NDC|500||MG|||G|
RXR|PO|
h) Nursing application Medications Administration results to pharmacy, treatment, or Order Entry application.
MSH|...
PID|...
ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|||||||
RXA|1|1|199012100615||0047-0402-30^Ampicillin 250 MG TAB^NDC|2|TAB||
RXR|PO|
The RXC segments are used when the RXO-level code does not fully describe the ordered entity, and the description requires more than a single code. Such "customized" orderable entities may use a "generic" code at the RXO level; e.g., <generic code> means "custom IV solution, see RXC segments for details." In general, a given pharmacy or treatment application will have CE-type RXO-level codes equivalent to:
RXCUSIV^Custom IV^Local (for nonstandard IVs)
RXCUSMIX^Custom Mixture^Local (for dermatology and other specialties)
RXCUSSLV^Custom Salve^Local (for dermatology and other specialties)
An order is sent from an Order Entry application to a pharmacy or treatment application as follows:
IV D5W < 1/2 NS 100 cc/hr with an additive of 20 meq KCl in every third liter, starting with the first bottle
Continuous for 2 days (December 10, 1993 8am to December 12, 1993 at 8am)
With a timing critical factor of 30 minutes
a) The ORC/RXO for the custom IV mixture and the two liters of NSD5W as entered on the Order Entry application
MSH|...
PID|...
ORC|NW|2045^OE||||E|^C^199312100800^199312120800^^TM30^^^^|
RXO|||3|L|IV|D5W WITH 1/2 NS WITH 20 MEQ KCL EVERY THIRD BOTTLE STARTING WITH
FIRST||W8&825&A^|N||||||||H30
RXR|IV|LA|IV-SET01^^L|
b) Pharmacy/treatments encoded version sent to Nursing Unit West 8 Room 825 Bed A
The pharmacy or treatment supplier sends the order as a parent/child set. This spawns, from the free text order 2045, two child orders with two precisely defined service requests. ORC-4-quantity/timing represents the timing request of the time of the order creation; i.e., ORC-4-quantity/timing represents the requested time. RXE-1-quantity/timing represents the pharmacy or treatment suppliers interpretation of the order.
MSH|...
PID|...
ORC|PA|2045^OE|123^PH||||E|^C^199312100800^199312120800^^TM30^^^^
The first fully encoded child order is the order for the custom IV. This is a continuous, repeating order, the first of a cyclic group with a maximum number of two repetitions. The first repeat starts at the start date/time of 199312100800. This order can itself be a parent order and spawn individual give orders and/or it can be sent to an administering system (as in this example) which will be responsible for handling the "give" parts of the transactions.
ORC|CH|2045^OE|124^PH|||E||2045&OE^123&PH|
RXE|^C^H10^199312100800^199312120800^TM30^^^^S&&&125&PH&*ES+0M&2|RXCUSIV^Custom
IV^L||1|L|IV||W8&825&A|N|||||||RX#1256|||||||H10|100|CC/HR
RXR|IV|LA|IV-SET01^^L|
RXC|B|IVDEX05^D5W WITH 1/2 NS^L|1|L
RXC|A|CHEM_KCL^KCL^L|20|MEQ
The second fully encoded child order is for the plain D5W solution. It is the second part of a cyclic order group, and starts as soon as the first repetition of order with filler order number 124^PH is done (end-to-start with no intervening time increment). It has a maximum number of two repetitions. This order can itself be a parent order and spawn individual give orders and/or it can be sent to an administering system (as in this example) which will be responsible for handling the "give" parts of the transactions.
ORC|CH|2045^OE|125^PH|||E||2045&OE^123&PH|
RXE|^C^H20^199312101800^199312120800^TM30^^^^S&&&124&PH&ES+0M&2|IVDEX05^D5W WITH 1/2
NS^L||2|L|IV||W8&825&A|N||||||RX#1256||||||||H20|100|CC/HR
RXR|IV|LA|IV-SET01^^L|
c) Pharmacy/treatments give instructions (for the custom IV order only)
If the nursing system does not decode the RDE messages, but instead required the individual give messages, the following message can be used. It carries the instructions to the Nursing unit for administering the (first child) IV. It is also the pharmacy or treatment suppliers (dispense audit) record. The optional RXC segments are used to give a full description of the custom IV solution. In this example, RXG-3-quantity/timing represents the actual time the pharmacy or treatment supplier is requesting that the drug or treatment be given. The order sequencing component of quantity/timing is not needed in this message.
MSH|...
PID|...
ORC|RE|2045^OE|124^PH|||E|^C^199312100800^199312120800^^TM30^^^^|2045&OE^123&PH|||||||
RXG|1||^C^H10^199312100800^199312101800^^TM30|RXCUSIV^Custom IV^L|1||L|
IV|||W8&825&A|||H10|100|CC/HR
RXR|IV|LA|IV-SET01^^L|
RXC|B|IVDEX05^D5W WITH 1/2 NS^L|1|L
RXC|A|CHEM_KCL^KCL^L|20|MEQ
d) Nursing application Medication Administration results to the pharmacy or treatment supplier or Order Entry application
A message is sent from Nursing when the first bottle of Custom Mixture has been administered. A second message would be sent from Nursing when the NS is administered.
MSH|...
PID|...
ORC|RE|2045^OE|124^PH|||E|^C^199312100800^199312120800^^TM30^^^^||||||||
RXA|1|1|199312100800|199312101800|RXCUSIV^Custom IV^L|1|L|IV|||W8&825&A|H10
RXR|IV|LA|IV-SET01^^L|
This completes the first series of messages for this drug/treatment administration.
HL7 Delimiters: <cr> = segment terminator; | = field separator; ^ = component separator; & = subcomponent separator; ~ = repetition indicator; \ = escape character
Encoding Note: For readability, these examples do not show encoding of the subcomponents of the Give Codes (CE data type) in the RXC and RXO segments. In practice, the subcomponents should be encoded as described in the HL7 specification.
a) Example #1
D5/0.45NaCl 1000mL with 20mEq KCl in every 3rd bottle. Start the KCl in the 3rd bottle of this order. Run in at a rate of 100mL/hr.
(Other message data: placer order #123, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing= Cyclical)
This order may be expressed using a parent/child relationship. The parent order consists of an ORC (and an RXO, although I did not completely elaborate one in this example) that contains order level information. The repeating bottle cycle of D5/0.45NaCl 1000mL followed by D5/0.45NaCl 1000mL followed by D5/0.45NaCl + 20mEq KCL 1000mL is represented by three child segments. The Placers system may be treating this as a single order with two bottles, A (D5/0.45NaCl 1000mL @ 100mL/hr) and B (D5/0.45NaCl + 20mEq KCL 1000mL @ 100mL/hr), repeating in the cycle of A-A-B.
The parent:
ORC|NW|123^SMS|||||1^C^^199411280900^^R^^^^C|...
RXO|Cyclic IV|...
The first child:
ORC|CH|123A1^SMS|||||1^C^^^^^^^^C&123B&SMS&&&*ES+0M|123|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/.45NACL|1000|ML|<cr>
The second child:
ORC|CH|123A2^SMS|||||1^C^^^^^^^^C&123A1&SMS&&&ES+0M|123|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/.45NACL|1000|ML|<cr>
The third child:
ORC|CH|123B^SMS|||||1^C^^^^^^^^C&123A2&SMS&&&#ES+0M|123|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/.45NACL|1000|ML|<cr>
RXC|A|KCL|20|MEQ|<cr>
Discussion points:
Placer Order Number - Three alternatives must be discussed for placer order number.
Each child could have its own placer order number.
Each child could have the order number of the parent plus some appended identifier (for examples, 123A or 123.A or 123.1 etc.) that labels each child or each unique combination of ingredients. (It is noteworthy that this alternative obviates the need for the previously proposed subcomponent ORC-7-Quantity/Timing-8-Placer Sequence ID.)
In addition to the appended identifier discussed in B above, a further suffix could be attached to uniquely identify each repetition of a particular member of the sequence. The example (a cycle of bottles A and B in the sequence A-A-B) identified the order numbers of the children as 123A1, 123A2, and 123B, thereby enabling the quantity/timing to be completely unambiguous. This could be expressed many other ways, such as 123A.1 or 123.A.1 or 123.A#1 etc. HL7 does not specify a format for the expression of order number suffixes, nor does it specify a delimiter to use for such a purpose.
Sequence Condition Value - In this example, the first child contains an asterisk (*) as the first character of the Sequence Condition Value and the third (last) child contains a pound sign (#).
The asterisk and pound sign are important for designating the first and last bottles especially when children are sent in separate messages, although this example is not constructed that way.
Note that computing the duration of the bottle is dependent upon the presence of all of the following fields:
RXO-2-requested give amount-minimum
RXO-4-requested give units
RXC-3-component amount
RXC-4-component units
For cyclic IV orders, these fields are all required in order to determine how long each occurrence of a child will last.
While HL7 allows either sending the parent and children in one message or sending the parent and children in separate messages, it appears simpler and therefore recommended to have the parent and all children included in a single message. The example is constructed that way.
b) Example #2
D5W + 40mEq KCl 1000mL alternating with D5/LR + 20mEq KCl 1000mL at 125mL/hr
(Other message data: placer order #124, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing= Cyclical)
This example is a variation on the first example where two different base solutions are used. In this example, the Placers system deals with this as one order with two alternating bottles, A (D5W + 40mEq KCl 1000mL @ 125mL/hr) and B (D5/LR + 20mEq KCl 1000mL @ 125mL/hr) in the cycle A-B. The principles discussed in Example #1 apply equally to this example.
The parent:
ORC|NW|124^SMS|||||1^C^^199411280900^^R^^^^C|...
RXO|Cyclic IV|...
The first child:
ORC|CH|124A^SMS|||||1^C^^^^^^^^C&124B&SMS&&&*ES+0M|124|...
RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5W|1000|ML|<cr>
RXC|A|KCL|40|MEQ|<cr>
The second child:
ORC|CH|124B^SMS|||||1^C^^^^^^^^C&124A&SMS&&&#ES+0M|124|...
RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/LR|1000|ML|<cr>
RXC|A|KCL|20|MEQ|<cr>
c) Example #3
D5/0.45NaCl 1000mL with 20mEq KCl in every 3rd bottle. Start the KCl in the 3rd bottle of this order. Add 10mL of Multivitamins to the one bag daily. Run in at a rate of 100mL/hr.
(Other message data: placer order #134, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing= Cyclical. Note that the encoding of the Multivitamins statement in the above order, adding Multivitamins to one IV bag each day, may vary by institution to put it into the first or last bottle of the day.)
This order may be expressed using a parent/child relationship. The parent order consists of an ORC (and an RXO, although I did not completely elaborate one in this example) that contains order level information. The repeating bottle cycle of D5/0.45NaCl 1000mL followed by D5/0.45NaCl 1000mL followed by D5/0.45NaCl + 20mEq KCL 1000mL is represented by three child segments. This order is complicated by the request to add one component into any one of the three repeating bottles, depending upon which of the bottles will occur first on any particular day. Further complicating this order is a rate of infusion (10 hours for a 1000mL bottle) which results in a fractional number of daily administrations. Most legacy systems have a great deal of trouble accommodating orders like this within their existing database structures, however there a few vendors who now are able to handle the situation. The Placers system may be treating this as a single order with two bottles, A (D5/0.45NaCl 1000mL @ 100mL/hr) and B (D5/0.45NaCl + 20mEq KCL 1000mL @ 100mL/hr), repeating in the cycle of A-A-B with a cyclical component (Multivitamins).
The parent:
ORC|NW|134^SMS|||||1^C^^199411280900^^R^^^^C|...
RXO|Cyclic IV|...
The first child:
ORC|CH|134A1^SMS|||||1^C^^^^^^^^C&134B&SMS&&&*ES+0M|134|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/.45NACL|1000|ML|<cr>
The second child:
ORC|CH|134A2^SMS|||||1^C^^^^^^^^C&134A1&SMS&&&ES+0M|134|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/.45NACL|1000|ML|<cr>
The third child:
ORC|CH|134B^SMS|||||1^C^^^^^^^^C&134A2&SMS&&&#ES+0M|134|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/.45NACL|1000|ML|<cr>
RXC|A|KCL|20|MEQ|<cr>
The fourth child:
ORC|CH|134X^SMS|||||1^Q1D^^^^^^^^|134|...
RXO|MULTIVITAMINS|10||ML|INJECTABLE|...
Discussion points:
This method for accommodating the Multivitamins Daily scenario does not pretend to be the best or only way to express the message, but simply demonstrates adapting the current specification to a highly complex order without adding new components.
The Multivitamins component may be sent as a fourth child.
In this example, its ORC-7-quantity/timing includes an interval of "Q1D" (every 1 days).
Its order number consists of the placers parent order number plus an appended identifier (X in the above example) that labels this child as a special case. This convention would need to be agreed upon by sending and receiving applications.
d) Example #4
D5W + 40mEq KCl 1000mL alternating with D5/LR + 20mEq KCl 1000mL alternating with D5/0.45NaCl 1000mL. Infuse the D5W and D5/0.45 at 125mL/hr, and the D5/LR at 100mL/hr.
(Other message data: placer order #177, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing= Cyclical)
This example is another variation of Example 1 where the rate for each bottle is different, and this can be expressed within the RX segments of the children using current components. In this example, the Placers system deals with this as one order with three alternating bottles, A (D5W + 40mEq KCl 1000mL @ 125mL/hr) , B (D5/LR + 20mEq KCl 1000mL @ 100mL/hr) , and C (D5/0.45NaCl 1000mL @ 125mL/hr) in the cycle A-B-C. The principles discussed in Example #1 apply equally to this example.
The parent:
ORC|NW|177^SMS|||||1^C^^199411280900^^R^^^^C|...
RXO|Cyclic IV|...
The first child:
ORC|CH|177A^SMS|||||1^C^^^^^^^^C&177C&SMS&&&*ES+0M|177|...
RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5W|1000|ML|<cr>
RXC|A|KCL|40|MEQ|<cr>
The second child:
ORC|CH|177B^SMS|||||1^C^^^^^^^^C&177A&SMS&&&ES+0M|177|...
RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/LR|1000|ML|<cr>
RXC|A|KCL|20|MEQ|<cr>
The third child:
ORC|CH|177C^SMS|||||1^C^^^^^^^^C&177B&SMS&&&#ES+0M|177|...
RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...
Requested Give Per (Time Unit): ...|H1|...
RXR|IV|<cr>
RXC|B|D5/0.45NACL|1000|ML|<cr>
R0R Pharmacy /Treatment Order Response
MSH Message Header
MSA Message Acknowledgment
[ERR] Error
{
QRD Query Definition
[QRF] Query Filter
[PID Patient Identification
{[NTE]}] Notes and Comments (for PID)
{
ORC Common Order
RXO Pharmacy/treatment Order
{RXR} Pharmacy/treatment Route
{[RXC]} Pharmacy/treatment Component
}
}
[DSC] Continuation Pointer
RAR Pharmacy/treatment Administration Information
MSH Message Header
MSA Message Acknowledgment
[ERR] Error
{
QRD Query Definition
[QRF] Query Filter
[PID Patient Identification
{[NTE]}] Notes and Comments (for PID)
{
ORC Common Order
[
RXE Pharmacy/treatment Encoded Order
{RXR} Pharmacy/treatment Route
{[RXC]} Pharmacy/treatment Component
]
{RXA} Pharmacy/treatment Administration
RXR Pharmacy/treatment Route
}
}
[DSC] Continuation Pointer
RDR Pharmacy/treatment Dispense Information
MSH Message Header
MSA Message Acknowledgment
[ERR] Error
{
QRD Query Definition
[QRF] Query Filter
[PID Patient Identification
{[NTE]}] Notes and Comments (for PID)
{
ORC Common Order
[
RXE Pharmacy/treatment Encoded Order
{RXR} Pharmacy/treatment Route
{[RXC]} Pharmacy/treatment Component
]
{RXD} Pharmacy/treatment Dispense
{RXR} Pharmacy/treatment Route
}
}
[DSC] Continuation Pointer
RER Pharmacy/treatment Encoded Order Information
MSH Message Header
MSA Message Acknowledgment
[ERR] Error
{
QRD Query Definition
[QRF] Query Filter
[PID Patient Identification
{[NTE]}] Notes and Comments (for PID)
{
ORC Common Order
RXE Pharmacy/treatment Encoded Order
RXR Pharmacy/treatment Route
{[RXC]} Pharmacy/treatment Component
}
}
[DSC] Continuation Pointer
RGR Pharmacy/treatment Dose Information
MSH Message Header
MSA Message Acknowledgment
[ERR] Error
{
QRD Query Definition
[QRF] Query Filter
[PID Patient Identification
{[NTE]}] Notes and Comments (for PID)
{
ORC Common Order
[
RXE Pharmacy/treatment Encoded Order
{RXR} Pharmacy/treatment Route
{[RXC]} Pharmacy/treatment Component
]
{RXG} Pharmacy/treatment Give
{RXR} Pharmacy/treatment Route
}
}
[DSC] Continuation Pointer
The lab application requests pharmacy/treatment administration information for patient 12345, from 8/12/92 through 8/13/92.
MSH|...<CR>
QRD|19920814165645|R|D|9200231|||30^RD|12345|RAS<CR>
QRF|PHM|19920812000000|19920813235959<CR>
DSC<CR>
MSH|...<CR>
MSA|...<CR>
QRD|...<CR>
QRF|...<CR>
ORC|RE||R23<CR>
RXE|^BID^D5^199208120800^199208162000|10986^AMPICILLIN|250||MG<CR>
RXR|PO<CR>
RXA|1|1|199208120800|||250<CR>
RXA|2|2|199208122000|||250<CR>
RXA|3|3|199208130800|||250<CR>
RXA|4|4|199208132000|||250<CR>
ORC|RE||R76<CR>
RXE|^TID^D7^199208120600^199208182200|12796^ASPIRIN|325||MG<CR>
RXR|PO<CR>
RXA|1|1|199208120600|||325<CR>
RXA|2|2|199208121400|||325<CR>
RXA|3|3|199208122200|||325<CR>
RXA|4|4|199208130600|||325<CR>
RXA|5|5|199208131400|||325<CR>
RXA|6|6|199208132200|||325<CR>
DSC<CR>
The nursing sytem requests pharmacy/treatment dose information for patient 12345, from 8/12/92 through 8/13/92.
MSH|...<CR>
QRD|19920814172309|R|D|9200543|||100^RD|12345|RXG<CR>
QRF|PHM|19920812000000|19920813235959<CR>
DSC<CR>
MSH|...<CR>
MSA|...<CR>
QRD|...<CR>
QRF|...<CR>
ORC|RE||R23<CR>
RXE|^BID^D5^199208120800^199208162000|10986^AMPICILLIN|250||MG<CR>
RXR|PO<CR>
RXG|1||199208120701||250<CR>
RXG|2||199208121923||250<CR>
RXG|3||199208130702||250<CR>
RXA|4||199208131912||250<CR>
ORC|RE||R76<CR>
RXE|^TID^D7^199208120600^199208182200|12796^ASPIRIN|325||MG<CR>
RXR|PO<CR>
RXG|1||199208120459||325<CR>
RXG|2||199208121328||325<CR>
RXG|3||199208122101||325<CR>
RXG|4||199208130503||325<CR>
RXG|5||199208131311||325<CR>
RXG|6||199208132145||325<CR>
DSC<CR>
The order entry application requests pharmacy/treatment order information for patient 12345, from 8/12/92 through 8/13/92.
MSH|...<CR>
QRD|19920814181254|R|D|9200785|||45^RD|12345|RDE<CR>
QRF|PHM|19920812000000|19920813235959<CR>
DSC<CR>
MSH|...<CR>
MSA|...<CR>
QRD|...<CR>
QRF|...<CR>
ORC|RE|3346|R23<CR>
RXE|^BID^D5^199208120800^199208162000|10986^AMPICILLIN|250||MG<CR>
RXR|PO<CR>
ORC|RE|3987|R76<CR>
RXE|^TID^D7^199208120600^199208182200|12796^ASPIRIN|325||MG<CR>
RXR|PO<CR>
DSC<CR>