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7.2.1 ORU/ACK - unsolicited transmission of an observation message (event R01)

With the type (OBX) defined in this chapter, and the OBR defined in Chapter 4, one can construct almost any clinical report as a three-level hierarchy, with the PID segment defined in Chapter 3 at the upper level, an order record (OBR) at the next level and one or more observation records (OBX) at the bottom.

One result segment (OBX) is transmitted for each component of a diagnostic report, such as an EKG or obstetrical ultrasound or electrolyte battery.

ORU     Observational Results (Unsolicited)  Chapter
MSH     Message Header        2
{  
   
   [
    PID    Patient Identification      3
   [PD1]   Additional Patient Identification    3
      [{NTE}]  Notes and Comments       2
    [PV1    Patient Visit        3
      [PV2]]   Additional Patient Visit      3
   ]
    {
     [ORC]   Order common         4
      OBR   Observations Report ID      7
      {[NTE]}  Notes and comments       2
        {
         [OBX]  Observation/Result       7
          {[NTE]}  Notes and comments       2
        }   
 {[CTI]}   Clinical Trial Identifier      7
     }   
}   
[DSC]    Continuation Pointer        2

ACK     Acknowledgement       Chapter
MSH     Message header        2
MSA     Message acknowledgement      2

Note: The ORC is permitted but not required in this message. Any information that could be included in either the ORC or the OBR must be included in the OBR on reporting. Notice also that the ORU (and the QRY) messages accommodate reports about many patients.

Many report headers (OBR) may be sent beneath each patient segment, with many separate observation segments (OBX) beneath each OBR. Note segments (NTE) may be inserted after any of the above segments. The note segment applies to the entity that immediately precedes it, i.e., the patient if it follows the PID segment, the observation if it follows the OBR segment, and the individual result if it follows the OBX segment.

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