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MESSAGING GUIDE FOR INFLUENZA
TEST RESULT REPORTING
BY PUBLIC HEALTH LABORATORIES
ORU^R01
HL7 Version 2.3.1
Document Version ID: 1.0.2
September 15, 2009
Revision 1 dated June 18th, 2010
Centers for Disease Control and Prevention
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
REVISION HISTORY
Date
6/8/2007
Version
1.0.1
6/11/2007
6/12/2007
6/29/2007
7/10/2007
7/23/07
1/23/08
1/23/08
1/23/08
1/23/08
1/23/08
1.0.1
1.0.1
1.0.1
1.0.1
1.0.1
1.0.2
1.0.2
1.0.2
1.0.2
1.0.2
1/28/08
1/28/08
1.0.2
1.0.2
5/28/08
1.0.2
7/2/08
7/2/08
1.0.2
1.0.2
7/16/08
1.0.2
7/23/08
1.0.2
7/29/08
1.0.2
8/6/08
1.0.2
8/2208
1.0.2
7/21/09
1.0.2
7/30/09
1.0.2
8/12/09
1.0.2
Description
First draft of the PHLIP HL7 2.3.1 Messaging Specification that covers only the
ORU^R01 Unsolicited Transmission of an Observation
Added newly assigned Code System OIDs specific to PHLIP
Added sample messages
Added updates from discussions 6/13, 6/20 & 6/27
Final updates
Update to Data Element LAB330
Remove HL7 table reference in guide to follow PHIN Structure
Make birthdate and patient age, county and zip RE
Added requirements to business rules for retroactive reporting of flu
Added business rule to describe reporting “test not performed” and “absence finding”
Added business rule to note that messages not containing LAB202 (Specimen ID) in
OBX.3 will not pass validation as it is marked as Required in the Data Elements of
Interest.
Updated to Data Element TRAVEL05 to “Destination(s) Traveled To”
Added note in business rules to describe reporting of standard and local codes in CE
Data Type
Added business rule to describe reporting of non-influenza virus detected while
testing for influenza
Added business rule to describe reporting non-standard counties (DEM165)
Updated guide to reflect use of HL7 Table0396 rather than OIDs to identify Coding
Systems.
Also updated sample message and data elements of interest.
Updated Section 2.2 - Remove warning if same LAB202 repeats. Repeating LAB202
is acceptable if the value is identical
Change optionality for assigning authority for placer order number (ORC-2.3, OBR2.3) from RE to R.
Also added business rule describing the use of assigning authority.
Update examples with new HL70396 values (replace OIDs),
Add HL7 code system references to tables
In all XAD change value set to FIPS 5-2 and add in comment to use 2 letter alpha
codes in this field
In data elements of interest table changed program requirements for DEM162
(Patient Address State) from R to RE
Updated date,
Updated headers in message structure tables to match implementation profiles rather
than standards (change OPT to Usage and RPT to Cardinality.
Added explanation of RE into date elements of interest usage definitions
Update date
Add clarification on handling of unsupported fields
Changes per meeting with V+M and New States groups:
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
Date
Version
8/18/09
1.0.2
9/9/09
9/9/09
9/9/09
9/11/09
1.0.2
1.0.2
1.0.2
1.0.2
11/2/09
1.0.2
12/14/09
1.0.2_r1
3/3/2010
1.0.2_r1
3/26/2010
1.0.2_r1
4/14/2010
4/21/2010
4/27/2010
5/14/2010
6/18/2010
1.0.2_r1
1.0.2_r1
1.0.2_r1
1.0.2_r1
1.0.2_r1
Description
Changed verbiage on usage definitions
Changed ORC.2 from C to RE to match OBR.2
Dropped out OID table per 8/12/09 group decision
Pre-adopted MSH.21 from v2.5.1 to be able to indicate implementation guide version
used (from last week’s new state update in notes
Added verbiage to indicate need for reporting of negative influenza results under
reporting of non-influenza viruses
Updated sample message to match storyboard
Changed MSH.10, PID.3.1, OBR.3.1 and OBX.5.1(CX datatype) length to 30 per cr#
Changed ORC.3.1, OBR.2.1, ORC.2.1, OBR.29.1.1, OBR.29.2.1 length to 30
Added support for OBX.17.1, 17.2, 17.3 (Observation Method)
Changed numbering of OBR 10.8 to the proper 10.10 as per standard to report name
type code for colletor identifier
Changed v1.0.1 to v1.0.2 in footer and table of contents
Changed publication date in footer to September 15, 2009
Corrected the concept name for FLU002 in data element table to include “for
Influenza” (as it appears in example)
Added rows to MSH table, where content of component was lumped into main field:
MSH.7, MSH.9, MSH.11, PID.5.1,
Updated OBX.6 cardinality to CE and updated the rule to reflect OBX.2 = SN for
conditionality rule – need to think about using C to make it stronger and giving
explanation to use “1” anytime a value is unitless, for example a titer
Changed usage codes for LAB114 and LAB192 to C to match updated guide usage
for OBX.5 for those data types
Updated link to OID sheet and added link to HL70396 table
Clarified language regarding start of flu season
PID.3 Clarified language regarding Patient Identifier.
Sample message: Changed description from display name to LOINC shortname
Updated title page, footers and file name per CCB decision to publish 6/18/2010
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE OF CONTENTS
1
INTRODUCTION ................................................................................... 7
2
GENERAL INFORMATION FOR PHLIP VERSION 1.0.2 ........................... 7
2.1 UNSOLICITED RESULTS: FROM STATE-TO-CDC ONLY .................................... 7
2.2 SINGLE SPECIMEN PER ORU^R01 MESSAGE .............................................. 7
2.3 ORU^R01 MAY NOT INCLUDE ORDER INFORMATION ..................................... 8
2.4 CORRECTED RESULTS .......................................................................... 8
2.5 RATIO RESULTS ................................................................................ 8
2.6 NON-HUMAN SAMPLES ........................................................................ 8
2.7 REPORTING OF TRIPLETS IN CE DATA TYPE IN THE OBX.5 SEGMENT .................. 9
2.8 REPORTING “TEST NOT PERFORMED” AND “ABSENCE FINDING” ........................ 9
2.9 SPECIMEN ID (LAB202) IS REQUIRED ..................................................... 9
2.10 RETROACTIVE REPORTING OF FLU ......................................................... 10
2.11 REPORTING NON-INFLUENZA VIRUSES .................................................... 11
Example one: Non-Influenza virus detected (included in Encoding Guideline) .......... 11
Example two: Non-Influenza virus detected (not included in Encoding Guideline) ...... 12
2.12 USING THE CORRECT ASSIGNING AUTHORITY ............................................. 12
3
USE OF OBJECT IDENTIFIERS (OIDS) ................................................ 14
4
CODE SYSTEMS AND VALUE SETS....................................................... 14
5
HL7 MESSAGE FOR INFLUENZA TEST RESULT REPORT ....................... 15
5.1 HL7 MESSAGE PROFILE ATTRIBUTES ...................................................... 16
5.2 HL7 V2.3.1 MESSAGE ORU^R01 SYNTAX.............................................. 16
5.3 SEGMENT PROFILE ATTRIBUTES ............................................................ 18
5.4 MESSAGE HEADER (MSH) SEGMENT LEVEL PROFILE ................................... 21
5.5 PATIENT IDENTIFICATION (PID) SEGMENT LEVEL PROFILE ............................ 24
5.6 NEXT OF KIN/ASSOCIATED PARTIES (NK1) SEGMENT LEVEL PROFILE ............... 30
5.7 COMMON ORDER (ORC) SEGMENT LEVEL PROFILE ..................................... 32
5.8 OBSERVATION REQUEST (OBR) SEGMENT LEVEL PROFILE ............................ 36
5.9 OBSERVATION/RESULT (OBX) SEGMENT LEVEL PROFILE .............................. 46
5.10 NOTES AND COMMENTS (NTE) SEGMENT LEVEL PROFILE .............................. 58
6
PHLIP DATA ELEMENTS OF INTEREST ................................................ 59
6.1 COLUMN DEFINITIONS FOR ELEMENTS OF INTEREST TABLE ............................ 59
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6.2 DATA ELEMENTS OF INTEREST FOR UNSOLICITED RESULTS ............................ 60
7
SAMPLE MESSAGE .............................................................................. 72
7.1 STORYBOARD ................................................................................. 72
7.1.1 Sample ..................................................................................... 72
8
MISCELLANEOUS ............................................................................... 74
8.1 LINK TO APPLICATION & ORGANIZATIONAL OIDS...................................... 74
8.2 LINK TO PHINVADS ....................................................................... 74
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INDEX OF TABLES
Table 5-1. Message Profile Attributes ....................................................................... 16
Table 5-2. HL7 v2.3.1 Message ORU^R01 Syntax ...................................................... 17
Table 5-3. Segment Profile Attributes....................................................................... 19
Table 5-4. Message Header (MSH) Segment Profile – ORU^R01 Usage ......................... 21
Table 5-5. Patient Identification (PID) Segment Profile – ORU^R01 Usage..................... 24
Table 5-6. Next of Kin/Associated Parties (NK1) Segment Profile – ORU^R01 Usage ....... 30
Table 5-7. Common Order (ORC) Segment Profile – ORU^R01 Usage ........................... 33
Table 5-8. Observation Request (OBR) Segment Profile – ORU^R01 Usage ................... 36
Table 5-9. Observation/Result (OBX) Segment Profile – ORU^R01 Usage ...................... 46
Table 5-10. Notes and Comments (NTE) Segment Profile – ORU^R01 Usage ................. 58
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HL7 V2.3.1 DATA MESSAGING GUIDE FOR
INFLUENZA TEST RESULT REPORTING BY PUBLIC
HEALTH LABORATORIES
1
INTRODUCTION
Laboratory tests are essential for the control and prevention of
influenza. The accurate and rapid exchange of information about
influenza tests and results among public health laboratories and
their partners is essential to the prevention and control of influenza.
The purpose of this document is to specify the Health Level Seven
(HL7) messaging guide, as supported by laboratory information
systems, for the reporting of influenza test results. This document
describes the APHL/CDC pilot implementation of HL7 messages for
influenza testing in conformance with HL7 message standards.
An HL7 message guide is a precise and unambiguous specification
of an HL7 standard-defined message that has been analyzed for
use within a particular set of requirements. It is a particular style
or usage of a standard HL7 message, driven by use case analysis
and interaction modeling. An HL7 message guide defines both the
static structure and content of the message and the dynamic
message definition, such as defining the communication of a
message from the sending application to one or more receiving
applications.
2
GENERAL INFORMATION FOR PHLIP VERSION 1.0.1
2.1 UNSOLICITED RESULTS: FROM STATE-TO-CDC ONLY
This Messaging Guide (PHLIP version 1.0.1, HL7 version 2.3.1)
addresses only the ORU^R01 Unsolicited Observation message sent
from the state-to-CDC.
State-to-State messages and CDC-to-State messages will be
addressed in separate documents.
2.2 SINGLE SPECIMEN PER ORU^R01 MESSAGE
Only one (1) specimen is allowed per message.
There may be multiple OBRs, but each will have the same collection
information because all will be associated with one (1) specimen. If
a single message contains repeating Specimen IDs (LAB202), this is
acceptable if the IDs are identical. However, the message should
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error out, if there are multiple, non-matching Specimen IDs in a
single message.
2.3 ORU^R01 MAY NOT INCLUDE ORDER INFORMATION
Because the ORU^R01 is a result message, some ordering
information may or may not be included in the message (e.g., ORC2 Placer Order Number, OBR-2 Placer Order Number, ORC segment,
etc.).
2.4 CORRECTED RESULTS
A corrected result occurs when a previously final result report (i.e.,
an OBR and associated OBXs where OBR-25 was "Final" and all
OBX-11s were "Final") is resent with a change to a value in one or
more OBXs.
-
OBR-25 (Result Status): The status of the entire report is
marked as "C-Corrected" in OBR-25.
-
OBX-11 (Observation Result Status): The status of individual
OBXs is marked as either "Final" or "Corrected." The
corrected OBX values should have an OBX-11 status of "CCorrected." The OBXs that remain unchanged should have
an OBX-11 status of "F-Final." A minimum of one OBX must
be marked as corrected.
For this version of PHLIP, the CDC will expect only "Final" or
"Corrected" results.
2.5 RATIO RESULTS
Ratio results are not supported with PHLIP Version 1.0.1 of the
Messaging Guide.
2.6 NON-HUMAN SAMPLES
EPI is assuming that the specimens are only from human sources,
even if the virus originated in a different species (i.e. swine or
avian).
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2.7 REPORTING OF TRIPLETS IN CE DATA TYPE IN THE OBX.5
SEGMENT
Standard code should be reported in the 1st set of triplets. The
local codes transmitted in the 2nd set of triplets should be used to
further clarify the data passed in the standard codes. The
preference is to include both standard and local codes in the
message. However, if standard codes are not available, then local
codes should be sent. See the guidelines below:
BEST = Components 1 – 6
o
All six segments could be used for grouping and subgrouping of
data
Acceptable = Components 1 - 3
o
CDC would use the standard triplet for grouping purposes
Acceptable = Components 4 - 6
o
CDC would use local triplet as more descriptive versions of
standard codes, but may need to verify local code with lab
2.8 REPORTING “TEST NOT PERFORMED” AND “ABSENCE
FINDING”
States should not send blank OBX’s – if you find one agent, report
one agent, if you find n agents, report n agents using OBX 4 to
distinguish results
Use OBX.11 to report “Test Not Performed”.
OBX-11 = “N” - Not asked; used to affirmatively document
that the observation identified in the OBX was not sought
when the universal service ID in OBR-4 implies that it would
be sought.
OBX-11 = “X” - Results cannot be obtained for this
observation
2.9 SPECIMEN ID (LAB202) IS REQUIRED
Messages not containing LAB202 (Specimen ID) in OBX.3 will not
pass validation as it is marked as Required in the Data Elements of
Interest.
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2.10 RETROACTIVE REPORTING OF FLU
Background: Reporting for flu season starts on September 1st
and analysis is based on data from MMWRweek 40 to
MMWRweek 20. The season starts with a clean database. If a
state begins reporting after 9/1 using HL7, they will need to
be able to retroactively report all results using HL7 from 9/1 to
current date.
Date for Retroactive Reporting: 9/1
Data Fields to determine start date (in order):
1) Date of Receipt at Lab
a) HL7 Data Element: Specimen Received Date/Time
(OBR-14)
b) Data Elements of Interest: Receive Date (LAB334)
i) Date and time specimen is received at the lab.
The assumption is that labs WILL have this
information in their LIMS. Thus, it is the primary
field for checking the date
2) Specimen Collection Date
a) HL7 Data Element: Observation Date/Time (OBR-7)
b) Data Element of Interest: Collection Date (LAB163)
i) The date and time the specimen was collected.
3) Date of Illness Onset
a) HL7 Data Element: Date/Time of Illness Onset (OBX3 & OBX-5)
b) Data Element of Interest: Illness Onset Date
(11368-8)
i) Date and time of illness onset
4) Test Date
a) HL7 Data Element: Date/Time of the Observation
(OBX-14)
b) Data Element of Interest: Test Date (LAB108)
i) For PHLIP, this field will be used to record the
observation time.
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Note: CDC Influenza branch uses MMWR week numbers to
define flu season. The season runs from week 40 of one year
through week 39 of the following year. For this season, it
means that the season started on September 30, 2009 and
will end on September 27, 2010. The next season will start
September 28, 2010.
We can use the Date of Receipt at Lab if that is available and if
not, we would use, in order, the Specimen Collection Date,
Date of Illness Onset, or Test Date. If states are sending
retrospective data to cover an entire season, they could send
anything with a Date of Receipt at lab (or other appropriate
date if that isn't available) of September 1 or later.
2.11 REPORTING NON-INFLUENZA VIRUSES
If the sample was tested for Influenza, CDC does want to receive
the results even if a non-influenza virus was detected. CDC also
wants to receive all negative results for the Influenza tests, so they
can derive the denominator to calculate percent positive for the
respective test.
Approach for reporting non-influenza virus:
If the SNOMED code exists in the PHLIP Encoding Guideline,
report the specific SNOMED code for the non-influenza virus.
The non-influenza viruses have been added to both the
mapping workbook and the respiratory virus result value set in
the encoding guidelines. If SNOMED cannot be found, leave
1st triplet blank and report the virus name in the local code
section.
EXAMPLE ONE: NON-INFLUENZA VIRUS DETECTED (INCLUDED IN ENCODING
GUIDELINE)
OBX5:
o
OBX-5-1: 39164004
o
OBX-5-2: Human echovirus
o
OBX-5-3: 2.16.840.1.113883.6.96
o
OBX-5-4:
o
OBX-5-5: Human echovirus
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o
OBX-5-6: L
EXAMPLE TWO: NON-INFLUENZA VIRUS DETECTED (NOT INCLUDED IN
ENCODING GUIDELINE)
OBX5:
o
OBX-5-1:
o
OBX-5-2:
o
OBX-5-3:
o
OBX-5-4:
o
OBX-5-5:
o
OBX-5-6: L
2.12 USING THE CORRECT ASSIGNING AUTHORITY
According to HL7 the assigning authority is the unique name for the
system (or organization or agency or department) that created the
data (in this case the identifier). Also according to HL7, the
assigning facility is not considered part of the identifier, rather it's
historical information provided to identify the place or location the
identifier was first assigned. From the HL7 perspective, they can
certainly be the same.
The key thing is that the assigning authority, in combination with
the patient identifier, should create a globally unique identifier.
For instance, both IA and MN may use the paradigm First Three
Letters of last name with 3 digit number. John Doe would be ‘DOE001’ in MN (assuming John Doe was the first person in your system
with a name starting with ‘Doe’). Steve Doe would be ‘DOE-001’ in
IA.
CDC Receives the following in the HL7 message (using facility
OIDS):
o
PID3: DOE-001^^^&2.16.840.1.114222.4.1.10080&ISO (from
MN) – John Doe
o
PID3: DOE-001^^^&2.16.840.1.114222.4.1.10411&ISO (from
IA) – Steve Doe
This is ok because the concatenated ID is globally unique.
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The instance outlined above assumes that 'DOE-001' is unique
within the MN and IA facilities.
That may or may not be true. If you have multiple applications
that can create Patient IDs, the Facility OID may not be good
enough.
For instance, MN Application 1 may create ‘DOE-001’ for John Doe
and MN Application 2 may create ‘DOE-001’ for Steve Doe. In this
case, the facility OID in combination with the patient ID does not
provide a globally unique identifier.
In this case, you would need to use the Application OID. Of course,
this assumes that you cannot assign the same Patient Identifier to
different people within the same application.
o
PID3: DOE-001^^^&2.16.840.1.114222.4.3.3.6.1.1&ISO
(From MN Application 1) – John Doe
o
PID3: DOE-001^^^&2.16.840.1.114222.4.3.3.6.1.2&ISO
(From MN Application 2) – Steve Doe
The key point is that the assigning authority, in combination
with the patient identifier, should create a globally unique
identifier.
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3
USE OF OBJECT IDENTIFIERS (OIDS)
To have computers manipulate information about objects, those
objects, and occasionally the records about the objects, must be
uniquely identified in some way. HL7 has identified object
identifiers (OIDs)1 as the preferred mechanism for the
unambiguous global identification of for coding systems, vocabulary
items, messaging partners, and well-known entities.
4
CODE SYSTEMS AND VALUE SETS
Successful message implementation requires that transmitted
messages (message instances) contain valid values for coded fields.
PHIN messaging uses the HL7-defined code sets where these have
been identified and published by HL7. For “user-defined” tables, it
uses those values developed by PHIN messaging for use in public
health. However, all tables are implemented using PHIN vocabulary
principles. It is important to note that code sets are relatively
dynamic and subject to change between publications of these
implementation guides.
Every code value passed in a message instance is drawn from a
code system that has an associated HL7 code from Table 0396 as
an identifier. In general, the coded values allowed in a field
a) may be drawn from more than one code system, and
b) may be a subset of the codes from a given coding system.
Combining (a) and (b) makes it possible for the allowed code value
to be a combination of multiple subsets drawn from multiple coding
systems. The subsets of the codes that are legal for a particular
field are identified by an HL7 construct known as a "value set." A
value set is a collection of coded values drawn from code systems.
Value sets serve to identify the specific set of coded values for the
The International Organization of Standardization (ISO) has developed the OID mechanism for the
assignment of globally unique identifiers to any type of object in a decentralized way that retains some
traceability of the object so identified. The Internet Engineering Task Force (IETF) realized the utility of
this mechanism and formalized it in RFC 1778. This was further refined after comments and expressed
desires for increased usability on the World Wide Web and released again in RFC 2252. The World
Wide Web Consortium (W3C) supports the use of OIDs, and they are consistent with the
implementation of the Domain Name System/Service (DNS) on the Web.
1
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
message from the universe of coded values across all coding
systems.
The segment tables in the following sections identify the Value Set
Name used for each supported field containing a coded value.
Fields that use the data type "CE" require that messages include
the HL7 code from Table 0396 that uniquely defines the coding
system as well as the coded value itself. Some of these precoordinated value sets must be quickly updated (or new ones
created) as new campaigns, new needs, and new sets of
observations are identified.
Value sets are identified by an OID, but this OID is not transmitted
in the message. However, the value set OID is useful and
important when vocabulary items are modified or replaced.
For reporting of standard values, the 1st set of triplets should
always contain Concept Code, Concept Name and the code from
HL7 Table 0396 to identify the coding system. References to
display names in the guide and vocabulary are informational only
and should not be used as standard values in the message.
Example (standard):
OBX3.1: 22827-0 (Concept Code)
OBX3.2: FLUA Subtyp XXX PCR (Concept Name)
OBX3.3: LN (Code for LOINC from Table 0396)
Example (PHLIP):
OBX3.1: PLT17 (Concept Code)
OBX3.2: Influenza Virus A H1 Real Time RT-PCR on clin
spec (Concept Name)
OBX3.3: PLT (Code for PHLIP Code from Table 0396)
5
HL7 MESSAGE FOR INFLUENZA TEST RESULT
REPORT
(HL7 V2.3.1 Message ORU^R01)
The HL7 V2.3.1 ORU^R01 Unsolicited Observation Message has
been selected for use within the Public Health Laboratory
Interoperability Project for communication of test results among
public health partners.
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Segments that are NOT documented in this guide are considered
NOT SUPPORTED. Inclusion of any segment that is not supported
will result in the creation of an error message.
The abbreviated terms and their definitions used to describe the
Message Profile are detailed in the following table.
5.1 HL7 MESSAGE PROFILE ATTRIBUTES
Table 5-1. Message Profile Attributes
TABLE 5-1. MESSAGE PROFILE ATTRIBUTES
ABBREVIATION
Segment
Name
Usage
Cardinality
Description
DEFINITION
• Three-character code for the segment and the abstract syntax (e.g., the
square and curly braces). Note that for segment groups there is no segment
code present, but the square and curly braces will still be present.
• [ XXX ]
Optional
• { XXX }
Repeating
• XXX
Required
• [{ XXX }]
Optional and Repeating
Name of the segment or segment group element.
Use of the segment for PHLIP. Indicates if the segment is required, optional, or
conditional in a message. Legal values are:
• R – Required. Must always be populated.
• O – Optional.
• C – Conditional. Must be populated based on computable Conditionality
Statement.
• X – Not used.
Minimum and maximum number of times the segment may appear.
• [0..0] Segment never present.
• [0..1] Segment may be omitted and can have, at most, one occurrence.
• [1..1] Segment must have exactly one occurrence.
• [0..n] Segment may be omitted or may repeat up to n times.
• [1..n] Segment must appear at least once, and may repeat up to n times.
• [0..*] Segment may be omitted or repeat an unlimited number of times.
• [1..*] Segment must appear at least once, and may repeat unlimited
number of times.
• [m..n] Segment must appear at least m and at most n times.
Explanation of the use of the segment.
5.2 HL7 V2.3.1 MESSAGE ORU^R01 SYNTAX
The 2.3.1 version ORU^R01 abstract message has been
constrained for PHLIP Influenza Test Result Reporting as follows:
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Table 5-2. HL7 v2.3.1 Message ORU^R01 Syntax
TABLE 5-2. HL7 V2.3.1 MESSAGE ORU^R01 SYNTAX
SEGMENT
NAME
HEADER Begin
MSH
Message Header
USAGE
CARDINALITY
DESCRIPTION
R
[1..1]
R
[1..1]
The Message Header (MSH) Segment
contains information explaining how to
parse and process the message. This
includes identification of message
delimiters, sender, receiver, message
type, timestamp, etc.
R
[1..1]
The Patient Group is required for
PHLIP. This is a deviation from the
HL7 Version 2.3.1 standard.
HEADER End
PATIENT GROUP Begin
PID
Patient Identification
R
[1..1]
The Patient Identification (PID)
segment contains patient identifying
and demographic information. The PID
is required for PHLIP.
[NK1]
Next-of-Kin/ Associated
Parties
O
[0..1]
The Next-of-Kin/Associated Parties
(NK1) segment contains the
relationship information of patient and
others. If the subject of the testing is
something other than a person, the
NK1 will document the person or
organization responsible for, or owning,
the subject. For patients who are
persons, the NK1 documents the next
of kin of the patient.
Notes and Comments
O
[0..*]
The Notes and Comments (NTE)
segment for the NK1 Segment can be
used to carry any associated party’s
related comments.
R
[1..*]
The Order_Observation group is
required and may repeat. This means
that multiple test results may be
reported on a single specimen.
O
[0..1]
The Common Order (ORC) segment
identifies basic information about the
order for testing of the specimen. This
segment includes identifiers for the
order, who placed the order, when it
was placed, etc.
[NTE]
PATIENT GROUP End
{
[ORC]
ORDER_OBSERVATION
Begin
Common Order
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TABLE 5-2. HL7 V2.3.1 MESSAGE ORU^R01 SYNTAX
SEGMENT
OBR
[NTE]
{
}
}
NAME
USAGE
CARDINALITY
DESCRIPTION
Observation Request
R
[1..1]
The Observation Request (OBR)
segment is used to capture information
about a single test being performed on
the specimen, or to report information
about patient and specimen.
Notes and Comments
O
[0..*]
The Notes and Comments (NTE)
segment for the OBR Segment can be
used to carry any order-related
comments.
R
[1..*]
For PHLIP, the Observation group is
required in the ORU^R01 message.
This is a deviation from the HL7
Version 2.3.1 standard.
OBSERVATION Begin
OBX
Observation/Result
R
[1..1]
The Observation/Result (OBX)
segment following the OBR is used for
observations regarding the test
ordered. For instance, this may be
used to capture test results, the
specimen identifying information, and
epidemiologically important information
regarding the case diagnosis, such as
patient vaccination history, travel
history, treatment history, etc. For
PHLIP, the OBX is required in the
ORU^R01 message. This is a
deviation from the HL7 Version 2.3.1
standard.
[NTE]
Notes and Comments
O
[0..*]
The Notes and Comments (NTE)
segment for the OBX segment can be
used to carry any observation-related
comments.
OBSERVATION End
ORDER_OBSERVATION
End
5.3 SEGMENT PROFILE ATTRIBUTES
Fields or components that are NOT documented in this guide are
considered NOT SUPPORTED. Inclusion of any field or component
that is not supported will result in the creation of an error message.
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The abbreviated terms and their definitions used in the ORU^R01
segment profile are detailed in the following table.
Table 5-3. Segment Profile Attributes
TABLE 5-3. SEGMENT PROFILE ATTRIBUTES
ABBREVIATION
DEFINITION
Seq
Sequence of the elements as they are numbered in the HL7 segment.
Len
PHIN maximum length of the element. Length of an element is calculated using the
following rules:
Field length = (Sum of all supported component lengths) + (component number of
the last supported component) – 1.
Component length = (Sum of all supported sub-component lengths) + (subcomponent number of the last supported component) – 1.
Lengths should be considered recommendations, not absolutes. The receiver can
truncate fields, components and sub-components that are longer than the
recommended length. The receiver should continue to process a message even
when a field, component, or sub-component length exceeds the maximum
recommended length identified in this specification.
DT
Data type used by PHIN for HL7 element.
Indicator whether a data element is required, optional, or conditional in a message.
Legal values are:
• R
Required. Must always be populated. May use “” (two sets of quote
marks) for a null value if no specific value is delineated in the
Description column of the table.
• RE2 Required, but may be empty (no values, no quotes)
• O
Optional.
• C
Conditional, must be populated, when condition is met, must be empty if
condition is not met.
• CE Conditional, must be populated, but may be empty when condition is
met, must be empty if condition is not met,
• X
Not used.
Usage
Note: A required field in an optional segment does not mean the segment must be
present in the message. It means that if the segment is present, the required
fields within that segment must be populated. The same applies to required
components of optional fields. If the field is being populated, then the required
components must be populated. The same applies to required sub-components
2
The element may be missing from the message, but must be sent by sending application if
there is relevant data. A conforming sending application must be capable of providing all ‘RE’
elements. If conforming sending application knows required values for the element, it must
send that element. If conforming sending application does not know the required values, then
that element will be omitted.
Receiving applications will be expected to process (save/print/archive, etc.) or ignore data
contained in the element, but must be able to successfully process the message if the element
is omitted (no error message should be generated because the element is missing).
Health Level Seven, Version 2.5, July 2003, Section 2.12.6.2
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TABLE 5-3. SEGMENT PROFILE ATTRIBUTES
ABBREVIATION
DEFINITION
of optional components. If a component is being populated, then the required
sub-components of that component must be populated.
Cardinality
Value Set Name
Minimum and maximum number of times the segment may appear.
• [0..0] Segment never present.
• [0..1] Segment may be omitted and can have, at most, one occurrence.
• [1..1] Segment must have exactly one occurrence.
• [0..n] Segment may be omitted or may repeat up to n times.
• [1..n] Segment must appear at least once, and may repeat up to n times.
• [0..*] Segment may be omitted or repeat an unlimited number of times.
• [1..*] Segment must appear at least once, and may repeat unlimited
number of times.
• [m..n]
Segment must appear at least m and at most n times.
Pre-coordinated tables used in public health messages, accessible via the Public
Health Information Network Vocabulary Access and Distribution Services at
http://www.cdc.gov/PhinVSBrowser/StrutsController.do.
HL7 Tbl
The HL7 table number as defined in the HL7 V2.3.1 (1999) standard.
Element Name
Descriptive name of the data element.
Description
Explanation of the use of the field/component/sub-component.
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5.4 MESSAGE HEADER (MSH) SEGMENT LEVEL PROFILE
The MSH Segment is used to define the intent, source, destination, and some specifics of the syntax of the message.
This segment includes identification of message delimiters, sender, receiver, message type, timestamp, etc. The
message header is required for the test result message.
Table 5-4. Message Header (MSH) Segment Profile – ORU^R01 Usage
TABLE 5-4. MESSAGE HEADER (MSH) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
1
1
ST
R
[1..1]
Field Separator
Character to be used as the field separator for the rest
of the message. The supported value is |, ASCII (124).
2
4
ST
R
[1..1]
Encoding Characters
Literal value: ‘ ^~\&’.
3
224
HD
O
[0..1]
Sending Application
Field that may be used to uniquely identify the sending
application for messaging purposes. If populated, it
will contain an OID that represents the sending
application instance. For this version of PHLIP, the
sending application will be the name and OID from the
state that is sending the message.
3.1
20
IS
RE
[0..1]
Namespace ID
Laboratory information system name.
3.2
199
ST
R
[1..1]
Universal ID
OID.
3.3
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’.
4
224
HD
R
[1..1]
Sending Facility
Unique identifier of the facility that sends the message.
The sending facility must be part of the PHIN OID
registry. For this version of PHLIP, the sending facility
will be the name and OID from the state that is sending
the message.
4.1
20
IS
RE
[0..1]
Namespace ID
Laboratory name.
4.2
199
ST
R
[1..1]
Universal ID
OID.
4.3
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’
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SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
5
224
HD
O
[0..1]
Receiving Application
Unique identifier of the receiving application for
messaging purposes. If populated, it will contain an
OID that represents the receiving application instance.
For this version of PHLIP, the receiving application will
always be the CDC application, as denoted in MSH-5.1
and MSH-5.2.
5.1
20
IS
RE
[0..1]
Namespace ID
Laboratory information system name.
Literal value: ‘US WHO Collab LabSys’
5.2
199
ST
R
[1..1]
Universal ID
Literal value: ‘2.16.840.1.114222.4.3.3.7’
5.3
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’.
6
224
HD
R
[1..1]
Receiving Facility
Unique identifier of the facility that is to receive the
message. This unique identifier must be part of the
PHIN OID registry. For this version of PHLIP, the
receiving facility will always be the CDC facility, as
denoted in MSH-6.1 & MSH-6.2.
6.1
20
IS
RE
[0..1]
Namespace ID
Laboratory name.
Literal value: ‘CDC–EPI Surv Branch’
6.2
199
ST
R
[1..1]
Universal ID
Literal value: ‘2.16.840.1.114222.4.1.10416’
6.3
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’
7
26
TS
R
[1..1]
Date/Time of Message Date and time the message was created by the
sending system. The user inputs values for the field
only as far as needed. When a system has only a
partial date/time, e.g., month, day, and year, but not
hour and minute, the missing values may be
interpreted as zeros.
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TABLE 5-4. MESSAGE HEADER (MSH) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
7.1
24
DTM R
[1..1]
Time
YYYY[MMDD[HH[MM[SS[.S[S[S[S]]]]]]]]][+/-ZZZZ],
where at least the first fourteen are used to specify to a
precision of "second.”
The time zone (+/-ZZZZ) is represented as +/-HHMM
offset from Coordinated Universal Time (UTC)
(formerly Greenwich Mean Time [GMT]), where +0000
or -0000 both represent UTC (without offset).
It is strongly recommended that the time zone be used
in PHIN messaging.
9
7
CM
R
[1..1]
Message Type
Literal value: ‘ORU^R01’.
9.1
3
ID
R
[1..1]
Message Code
Literal value: ‘ORU’. Null flavors are not allowed.
9.2
3
ID
R
[1..1]
Trigger Event
Literal value: ‘R01’. Null flavors are not allowed.
9.3
3
ID
?
?
Message Structure
Literal value: ‘ORU_R01’. Null flavors are not allowed.
10
30
ST
R
[1..1]
Message Control ID
String that uniquely identifies the message instance
from the sending application. Recommended to use a
counter.
11
3
PT
R
[1..1]
12
60
VID
R
[1..1]
Version ID
Literal value: "2.3.1."
21
424
EI
R
[1..1]
Message Profile
Identifier
Field used to reference or assert adherence to a
message profile.
Message profiles contain detailed explanations of
grammar, syntax, and usage for a particular message
or set of messages.
21.1
199
ST
R
[1..1]
Entity Identifier
Literal value: ‘PHLIP_ORU_v1.0.2’
Processing ID
Processing ID
(HL7)table# HL70103
Indicator of the intent for processing the message,
such as "T" - training, "D" - de-bugging, or "P" production. For PHLIP, this field will always contain
"P."
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TABLE 5-4. MESSAGE HEADER (MSH) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
21.2
20
IS
RE
[1..1]
Namespace ID
Recommended value: ‘PHIN_Profile_ID’.
21.3
199
ST
R
[1..1]
Universal ID
First instance literal value: ‘2.16.840.1.114222.4.10.3’.
21.4
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’
Constrained HL7
table #301
5.5 PATIENT IDENTIFICATION (PID) SEGMENT LEVEL PROFILE
The PID Segment is used as the primary means of communicating patient identification information. This segment
contains pertinent patient identifying and demographic information. The PID Segment is required in the patient
group. For PHLIP, the patient group is required. If the message sender has detailed patient information, and that
information is needed/required by the message receiver, this patient group will be used. For the PHLIP influenza test
result message, only one PID Segment is expected per message. If the message sender does not have sufficient
information to construct a legal PID Segment, such as a patient name and patient ID, the message sender should
send the default data as noted in the Description column, below.
Table 5-5. Patient Identification (PID) Segment Profile – ORU^R01 Usage
TABLE 5-5. PATIENT IDENTIFICATION (PID) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
1
4
SI
R
3
564
CX
R
CARDINALITY
VALUE SET NAME
[1..1]
[1..*]
ELEMENT NAME
DESCRIPTION
Set ID - PID
Literal value: "1."
Patient Identifier List
This field contains the list of identifiers (one or more)
used by the facility to uniquely identify a
patient (e.g., medical record number, billing number,
birth registry, national unique individual identifier,
etc.)
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TABLE 5-5. PATIENT IDENTIFICATION (PID) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
3.1
30
ST
R
[1..1]
Patient ID
. The assigning authority is required for PHLIP.
Note: If no Patient ID is available, the Specimen ID
should be defaulted into this field. For PHLIP, the
Specimen ID will be an observation sent in OBX5 (Observation Value) with a data type of "CX."
In the case where the Specimen ID is used in
place of the Patient ID, it should also be a
separate OBX.
3.4
252
HD
R
[1..1]
Assigning Authority
Entity that assigned the Identifier.
3.4.1
48
IS
O
[0..1]
Namespace ID
3.4.2
199
ST
R
[1..1]
Universal ID
OID.
3.4.3
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’.
3.5
25
IS
R
[1..1]
3.6
252
HD
O
[0..1]
Assigning Facility
3.6.1
48
IS
R
[1..1]
Namespace
3.6.2
199
ST
R
[1..1]
Universal ID
OID.
3.6.3
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’.
5
236
XPN R
[0..*]
Patient Name
5.1
50
ST
RE
[0..1]
Last Name
5.1.1
50
ST
RE
[0..1]
Surname
Identifier Type
Composite value set:
values from HL7
table# 203 or
PHVS_IdentifierType
_CDC
Identifier Type Code
Facility that assigned the Identifier.
Note that if a patient name is not available, make the 1st
repeat of PID-5 empty. The 2nd repeat should contain an
“S” (code for pseudonym) in the Name Type Code
component (~^^^^^^S)
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TABLE 5-5. PATIENT IDENTIFICATION (PID) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
5.2
50
ST
RE
[0..1]
First Name
5.3
50
ST
RE
[0..1]
Middle Initial/Middle
Name
5.4
20
ST
RE
[0..1]
Suffix
5.5
20
ST
RE
[0..1]
Prefix
5.6
20
IS
RE
[0..1]
Degree License
Certification (HL7)
table# 360
Degree
5.7
20
ID
RE
[0..1]
Name Type (HL7)
table# 200
Name Type Code
7
26
TS
RE
[0..1]
8
1
IS
RE
[0..1]
10
703
CE
RE
10.1
50
ST
C
[0..1]
10.2
100
ST
O
[0..1]
10.3
199
ID
C
[0..1]
Administrative Sex
(HL7) table# 1
[0..*]
Race Category
(subset of
PH_RaceAndEthnicit
y_CDC)
DESCRIPTION
Date/Time of Birth
Patient's date and time of birth.
Sex
Patient's sex.
Race
Patient's race(s).
Identifier
Standardized code.
Rule of conditionality: The standard code component
is mandatory unless there is no standard to match the
local value passed by the application. An attempt will
be made by the sender to map the local value to the
standard. In the case that no standard code was
found, this field may be blank.
Text
Standardized description.
Coding System (HL7) Name of Coding
table# 396
System
HL7 identifier for Coding System (e.g. “LN” = LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
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TABLE 5-5. PATIENT IDENTIFICATION (PID) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
10.4
50
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code component is
mandatory if there is no standard to match the local
value passed by the application AND there is no text
present in component 5.
10.5
100
ST
C
[0..1]
Alternate Text
Local description. Note that if the field is collected as
text in the application, this may be the only field
populated if the data type is "Coded."
Rule of conditionality: Required if no standardized
code or local code value passed.
10.6
199
ID
C
[0..1]
Name of Alternate
Coding System
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
11
608
XAD RE
[0..*]
Patient Address
Residence address of the patient.
If multiple patient addresses are sent, the 1st repeat
should contain the patient’s primary address.
Note: If the state is not sent in the message, the
receiver should default the sending system’s
state in PID-11.4.
11.1
100
ST
RE
[0..1]
Street Address
11.2
100
ST
RE
[0..1]
Other Designation
11.3
100
ST
RE
[0..1]
City
11.4
20
ST
RE
[0..1]
State (FIPS_5-2)
State or Province
Reference the FIPS 5-2 alpha codes here, though this
is not a coded field, so no coding system will be
identified.
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SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
11.5
10
ST
RE
[0..1]
11.6
100
ID
RE
[0..1]
Country
Country
(PH_Country_ISO_31
66-1)
11.7
20
ID
RE
[0..1]
Address Type (HL7)
table# 190
11.8
50
ST
RE
[0..1]
11.9
100
IS
RE
[0..1]
22
703
CE
RE
[0..1]
22.1
50
ST
C
[0..1]
22.2
100
ST
O
[0..1]
22.3
199
ID
C
[0..1]
Zip or Postal Code
DESCRIPTION
US Zip Codes, Zip+4 and Canadian Postal Codes will
be supported.
Address Type
Other Geographic
Designation
May be used for MSAs (Metropolitan and Micropolitan
Statistical Areas). Source:
http://www.whitehouse.gov/omb/bulletin
s/fy2007/b07-01.pdf
County
County/Parish
(PH_County_FIPS_64)
Ethnic Group
Field that defines the patient as Hispanic, NonHispanic or Unknown.
Ethnicity Group
(subset of
PH_RaceAndEthnicit
y_CDC) including
Unknown (subset of
PH_NullFlavor_HL7_
V3)
Identifier
Standardized code.
Rule of conditionality: The standard code component
is mandatory unless there is no standard to match the
local value passed by the application. An attempt will
be made by the sender to map the local value to the
standard. In the case that no standard code was
found, this field may be blank.
Text
Standardized description.
Coding system (HL7)
table 0396
Name of Coding
System
HL7 identifier for Coding System (e.g. “LN” = LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-5. PATIENT IDENTIFICATION (PID) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
22.4
50
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code component is
mandatory if there is no standard to match the local
value passed by the application AND there is no text
present in component 5.
22.5
100
ST
C
[0..1]
Alternate Text
Local description. Note that if the field is collected as
text in the application, this may be the only field
populated if the data type is Coded.
Rule of conditionality: Required if no standardized
code or local code value passed.
22.6
199
ID
C
[0..1]
Name of Alternate
Coding System
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
29
26
TS
RE
[0..1]
Patient Death Date
and Time
Date and time of patient’s death, if the patient is known
to be deceased at the time of the message.
30
1
ID
RE
[0..1]
Yes No Indicator
(HL7)table# 136
Patient Death Indicator Indicator (Y) of patient’s death, if the patient is known
to be deceased at the time of the message. If
unknown, this field should be empty (no value, no
quotes).
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
5.6 NEXT OF KIN/ASSOCIATED PARTIES (NK1) SEGMENT LEVEL PROFILE
The NK1 Segment contains information regarding the patient's other related parties.
Table 5-6. Next of Kin/Associated Parties (NK1) Segment Profile – ORU^R01 Usage
TABLE 5-6. NEXT OF KIN/ASSOCIATED PARTIES (NK1) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
1
LEN
4
DT
SI
USAGE
R
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
[1..1]
Set ID - NK1
Literal Value: "1."
Name of the next of kin or associated party.
2
236
XPN RE
[0..1]
Name
2.1
50
ST
R
[1..1]
Last Name
2.2
50
ST
R
[1..1]
First Name
2.3
50
ST
RE
[0..1]
Middle Initial/Middle
Name
2.4
20
ST
RE
[0..1]
Suffix
2.5
20
ST
RE
[0..1]
2.6
20
IS
RE
[0..1]
Degree License
Certification (HL7)
table# 360
Degree
2.7
20
ID
RE
[0..1]
Name Type (HL7)
table# 200
Name Type Code
3
703
CE
RE
[0..1]
3.1
50
ST
C
[0..1]
3.2
100
ST
O
[0..1]
Prefix
Relationship (HL7)
table# 63
Relationship
Description of the relationship between the next of
kin/related party and the patient.
Identifier
Standardized code.
Rule of conditionality: The standard code component
is mandatory unless there is no standard to match the
local value passed by the application. An attempt will
be made by the sender to map the local value to the
standard. In the case that no standard code was
found, this field may be blank.
Text
Standardized description.
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-6. NEXT OF KIN/ASSOCIATED PARTIES (NK1) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
Coding system (HL7) Name of Coding
table# 0396
System
DESCRIPTION
3.3
199
ID
C
[0..1]
HL7 identifier for Coding System (e.g. “LN” = LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
3.4
50
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code component is
mandatory if there is no standard to match the local
value passed by the application AND there is no text
present in component 5.
3.5
100
ST
C
[0..1]
Alternate Text
Local description. Note that if the field is collected as
text in the application, this may be the only field
populated if the data type is Coded.
Rule of conditionality: Required if no standardized
code or local code value passed.
3.6
199
ID
C
[0..1]
Name of Alternate
Coding System
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
4
608
XAD O
[0..*]
Address
The address of the next of kin/associated party.
If multiple addresses are sent, the 1st repeat should
contain the next of kin’s primary address.
Note: If the state is not sent in the message, the
receiver should default the sending system’s
state in NK1-4.4
4.1
100
ST
O
[0..1]
Street Address
4.2
100
ST
O
[0..1]
Other Designation
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-6. NEXT OF KIN/ASSOCIATED PARTIES (NK1) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
4.3
100
ST
O
[0..1]
4.4
20
ST
RE
[0..1]
4.5
10
ST
O
[0..1]
4.6
100
ID
O
[0..1]
Country
Country
(PH_Country_ISO_31
66-1)
4.7
20
ID
RE
[0..1]
Address Type (HL7)
table# 190
4.8
50
ST
O
[0..1]
DESCRIPTION
City
State (FIPS_5-2)
State or Province
Zip or Postal Code
Reference the FIPS 5-2 alpha codes here, though this
is not a coded field, so no coding system will be
identified.
US Zip Codes, Zip+4 and Canadian Postal Codes will
be supported.
Address Type
Other Geographic
Designation
May be used for MSAs (Metropolitan and Micropolitan
Statistical Areas). Source:
http://www.whitehouse.gov/omb/bulletin
s/fy2007/b07-01.pdf
4.9
100
IS
O
[0..1]
County
County/Parish
(PH_County_FIPS_64)
http://www.census.gov/geo/www/fips/fips.
html
5.7 COMMON ORDER (ORC) SEGMENT LEVEL PROFILE
The ORC Segment is used to transmit test order information. This segment includes identifiers for the order, who
placed the order, when it was placed, etc. The ORC Segment is optional in the Test Result (ORU) message. Any
information that could be included in either the ORC or the OBR must be included in the OBR on reporting.
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
Table 5-7. Common Order (ORC) Segment Profile – ORU^R01 Usage
TABLE 5-7. COMMON ORDER (ORC) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
1
2
ID
R
[1..1]
2
255
EI
RE
2.1
30
ST
2.2
20
2.3
VALUE SET NAME
ELEMENT NAME
Order Control Code (HL7)
table# 119
DESCRIPTION
Order Control
Order action to be performed with this specific
order message. For the PHLIP result message,
"RE" (observations to follow) is used.
[0..1]
Placer Order
Number
Unique identifying number assigned to the test
request or order by the system that initiated the
request for performance of the test.
Note: The same value is populated in ORC.2 and
OBR.2.
R
[1..1]
Entity Identifier
IS
RE
[0..1]
Namespace ID
Assigning authority.
199
ST
R
[1..1]
Universal ID
Field required to contain an assigning authority
OID for the application/ organization responsible
for creating the placer order number. The placer
order number is expected to be unique within this
assigning authority.
2.4
3
ID
RE
[0..1]
Universal ID type
Literal value: ‘ISO’.
3
255
EI
R
[1..1]
Filler Order Number
Order number associated with the filling
application.
Note: The same value is populated in ORC.3 and
OBR.3.
3.1
30
ST
R
[1..1]
Entity Identifier
3.2
20
IS
RE
[0..1]
Namespace ID
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-7. COMMON ORDER (ORC) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
3.3
199
ST
RE
[0..1]
Universal ID
Field required to contain an assigning authority
OID for the application/organization responsible
for creating the filler order number. The filler
order number is expected to be unique within this
assigning authority.
3.4
3
ID
RE
[0..1]
Universal ID Type
Literal value: ‘ISO’.
5
2
ID
RE
[0..1]
Order Status
Status of an order.
21
50
XON RE
[0..1]
Ordering Facility
Name
Name of the facility that placed the order.
21.1
50
ST
[1..1]
Organization Name
22
608
XAD RE
[0..*]
Ordering Facility
Address
22.1
100
ST
O
[0..1]
Street Address
22.2
100
ST
O
[0..1]
Other Designation
22.3
100
ST
O
[0..1]
City
22.4
20
ST
R
[1..1]
22.5
10
ST
O
[0..1]
22.6
100
ID
O
[0..1]
R
Order Status (HL7) table# 38
State (FIPS_5-2)
Country
(PH_Country_ISO_3166-1)
Address of the facility that placed the order.
If multiple addresses are sent, the 1st repeat
should contain the ordering facility’s primary
address.
Note: If the state is not sent in the message, the
receiver should default the sending
system’s state in ORC-22.4.
State or Province
Reference the FIPS 5-2 alpha codes here
Zip/Postal Code
US Zip Codes, Zip+4 and Canadian Postal
Codes will be supported.
Country
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
HL7 V2.3.1 Messaging Guide for Influenza Test Result Reporting
Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-7. COMMON ORDER (ORC) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
22.7
20
ID
RE
[0..1]
22.8
50
ST
O
[0..1]
VALUE SET NAME
ELEMENT NAME
Address Type (HL7) table#
190
Address Type
Other Geographic
Designation
County (PH_County_FIPS_64)
DESCRIPTION
22.9
100
IS
RE
[0..1]
23
211
XTN
RE
[0..*]
23.2
20
ID
RE
[0..1]
Telecommunication Use Code
(HL7) table# 201
23.3
100
ST
RE
[0..1]
Telecommunication Equipment Telecom Equipment
Type (HL7) table# 202
Type
23.4
20
ST
RE
[0..1]
Email Address
23.5
3
NM
RE
[0..1]
Country Code
23.6
3
NM
RE
[0..1]
Area Code
May be used for MSAs (Metropolitan and
Micropolitan Statistical Areas). Source:
http://www.whitehouse.gov/omb/bull
etins/fy2007/b07-01.pdf
County/Parish
Ordering Facility
Phone Number
Telephone number of the facility placing the
order. The receiver must minimally support the
1st repeat when populating this field.
Email address, if sent, is a separate "repeat" with
appropriate Telecommunication Use Code and
Telecommunication Equipment Type.
Telecom use code
Example of email address format: x@x.x
Look-up service for area codes:
http://www.nanpa.com/nas/public/np
a_query_step1.do?method=resetNpaRe
portModel
23.7
17
NM
RE
[0..1]
Phone Number
23.8
20
NM
RE
[0..1]
Extension
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-7. COMMON ORDER (ORC) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
23.9
LEN
DT
20
ST
USA CARDIN
GE
RE
ALITY
VALUE SET NAME
ELEMENT NAME
[0..1]
DESCRIPTION
Any Text
5.8 OBSERVATION REQUEST (OBR) SEGMENT LEVEL PROFILE
The OBR Segment in the Test Result Message (ORU) is used to capture information about one test being performed
on the specimen or report information about patient and specimen.
Note: For PHLIP, only one specimen is allowed per ORU^R01 message.
Table 5-8. Observation Request (OBR) Segment Profile – ORU^R01 Usage
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
1
4
SI
R
[1..1]
Set ID - OBR
Sequence number of the OBR in relation to the Result
message to which it refers. The sequence number
should start at 1 and be incremented by 1 for each
OBR in the result message.
2
255
EI
RE
[0..1]
Placer Order Number
Unique identifying number assigned to the test request
or order by the system that initiated the request for
performance of the test.
Note: The same value is populated in ORC.2 and
OBR.2.
2.1
30
ST
R
[1..1]
Entity Identifier
2.2
20
IS
RE
[0..1]
Namespace ID
Assigning authority.
2.3
199
ST
R
[1..1]
Universal ID
Field required to contain an assigning authority OID for
the application/ organization responsible for creating
the placer order number. The placer order number is
expected to be unique within this assigning authority.
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
2.4
3
ID
RE
[0..1]
Universal ID Type
Literal value: ‘ISO’.
3
255
EI
R
[1..1]
Filler Order Number
Order number associated with the filling application.
Note: The same value is populated in ORC.3 and
OBR.3.
3.1
30
ST
R
[1..1]
Entity Identifier
3.2
20
IS
RE
[0..1]
Namespace ID
3.3
199
ST
RE
[0..1]
Universal ID
Field required to contain an assigning authority OID for
the application/organization responsible for creating
the filler order number. The filler order number is
expected to be unique within this assigning authority.
3.4
3
ID
RE
[0..1]
Universal ID Type
Literal value: ‘ISO’.
4
643
CE
R
[1..1]
Universal Service ID
Identifier code for the test. This will be used to pass
PHLIP orderable test codes.
4.1
20
ST
C
[0..1]
Lab Test Order
Identifier
(PHLIP Flu)
(Composite value set:
values from LOINC
Standardized code.
Rule of conditionality: The standard code component
is mandatory unless there is no standard to match the
local value passed by the application. An attempt will
be made by the sender to map the local value to the
standard. In the case that no standard code was
found, this field may be blank.
and PLT)
4.2
100
ST
O
[0..1]
4.3
199
ID
C
[0..1]
Text
Standardized description.
Coding system (HL7) Name of Coding
table# 0396
System
HL7 identifier for Coding System (e.g. “LN” = LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
Page 37
APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
HL7 V2.3.1 Messaging Guide for Influenza Test Result Reporting
Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
4.4
20
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code component is
mandatory if there is no standard to match the local
value passed by the application AND there is no text
present in component 5.
4.5
100
ST
C
[0..1]
Alternate Text
Local description. Note that if the field is collected as
text in the application, this may be the only field
populated if the data type is "Coded."
Rule of conditionality: Required if no standardized
code or local code value passed.
4.6
199
ID
C
[0..1]
Name of Alternate
Coding System
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
7
26
TS
R
[1..1]
Observation Date/Time The date and time the specimen was collected.
A minimum of year, month and day must be provided
when the actual date/time is known. For unknown
collection date/time use "0000".
10
337
XCN O
[0..1]
Collector Identifier
10.1
100
ST
O
[0..1]
ID Number
10.2
50
ST
O
[0..1]
Family Name
10.3
50
ST
O
[0..1]
Given Name
10.4
50
ST
O
[0..1]
Middle Name/Initial
10.5
20
ST
O
[0..1]
Suffix
10.6
20
ST
O
[0..1]
Prefix
This field will identify the person, department or facility
that collected the specimen.
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
HL7 V2.3.1 Messaging Guide for Influenza Test Result Reporting
Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
10.7
20
IS
O
[0..1]
Degree
10.10
20
IS
O
[0..1]
Name Type Code
14
26
TS
RE
[0..1]
Specimen Received
Date/Time
Date and time specimen is received at the submitter.
15
1060
CM
R
[1..1]
Specimen Source
Identifier of the type and/or source of specimen on
which a test is performed.
15.1
703
CE
R
[1..1]
Specimen Source
Name or Code
Identifier of the type and/or source of specimen on
which a test is performed. The SNOMED CT
specimen concepts will not be used to encode this
component in PHLIP. For this version of PHLIP, the
HL7 table 0070 will be used as the reference table for
OBR 15.1.
If specimen source is not known, enter the HL7 table
0070 item: "USUB” and "Unknown substance" in the
sub-components OBR-15.1.1 & 15.1.2, respectively.
15.1.1
50
ST
R
[1..1]
Identifier
Standardized code.
The standard code sub-component is mandatory
unless there is no standard to match the local value
passed by the application. An attempt will be made by
the sender to map the local value to the standard. If
the specimen source is not listed in table 0070, enter
"ORH" and "Other" in sub-components 15.1.1 & 15.1.2,
with the description of the specimen source in subcomponent 15.1.5 (Alternate Text).
15.1.2
100
ST
O
[0..1]
Text
Standardized description.
Specimen Source
(HL7) table#70
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
HL7 V2.3.1 Messaging Guide for Influenza Test Result Reporting
Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
Coding system (HL7) Name of Coding
table# 0396
System
DESCRIPTION
15.1.3
199
ID
R
[1..1]
15.1.4
50
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code sub-component
is mandatory if there is no standard to match the local
value passed by the application AND there is no text
present in sub-component 5.
15.1.5
100
ST
C
[0..1]
Alternate Text
Local description. Note that if the field is collected as
text in the application, this may be the only field
populated if the data type is "Coded."
Rule of conditionality: Required if standard code
(15.1.1) is “ORH” .
15.1.6
199
ID
C
[0..1]
15.4
354
CE
O
[0..1]
Body Site
For PHLIP, the 1st 3 sub-components of 15.4 are not
supported. The local information will be entered in the
Alternate Text sub-component OBR-15.4.5
15.4.4
50
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code sub-component
is mandatory if there is no standard to match the local
value passed by the application AND there is no text
present in sub-component 5.
Coding system (HL7) Name of Alternate
table# 0396
Coding System
HL7 identifier for Coding System (e.g. “LN” = LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
Page 40
APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
HL7 V2.3.1 Messaging Guide for Influenza Test Result Reporting
Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
Alternate Text
DESCRIPTION
15.4.5
100
ST
C
[0..1]
15.4.6
199
ID
C
[0..1]
Coding system (HL7) Name of Alternate
table# 0396
Coding System
16
591
XCN RE
[0..1]
Ordering Provider
16.1
100
ST
RE
[0..1]
Ordering Provider ID
16.2
50
ST
RE
[0..1]
Last Name
16.3
50
ST
RE
[0..1]
First Name
16.4
50
ST
RE
[0..1]
Middle Initial/Middle
Name
16.5
20
ST
RE
[0..1]
Suffix
16.6
20
ST
RE
[0..1]
Prefix
16.7
20
IS
RE
[0..1]
16.9
252
HD
O
[0..1]
Assigning Authority
16.9.1
48
IS
R
[1..1]
Namespace ID
16.9.2
199
ST
R
[1..1]
Universal ID
OID.
16.9.3
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’
Degree License
Certification (HL7)
table# 360
Local description. Note that if the field is collected as
text in the application, this may be the only field
populated if the data type is "Coded."
Rule of conditionality: Required if no standardized
code or local code value passed.
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
Identifier of the provider who ordered the testing being
performed.
Degree
Entity that assigned the ID.
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
Name Type (HL7)
table# 200
ELEMENT NAME
16.10
20
ID
RE
[0..1]
17
211
XTN RE
[0..*]
17.2
20
ID
RE
[0..1]
Telecommunication
Use Code (HL7)
table# 201
Telecom Use Code
17.3
100
ST
RE
[0..1]
Telecommunication
Equipment Type
(HL7) table# 202
Telecom Equipment
Type
17.4
20
ST
RE
[0..1]
17.5
3
NM
RE
[0..1]
Country Code
17.6
3
NM
RE
[0..1]
Area Code
DESCRIPTION
Name Type Code
Order Callback Phone
Number
Email Address
Phone number that can be called to obtain additional
clarification regarding the order.
Note: The receiver must minimally support the 1st
repeat when populating this field.
Email address, if sent, is a separate "Repeat" with
appropriate Telecommunication Use Code and
Telecommunication Equipment Type.
Example of email address format: x@x.x
Look-up service for area codes:
http://www.nanpa.com/nas/public/npa_qu
ery_step1.do?method=resetNpaReportMode
l
17.7
17
NM
RE
[0..1]
Phone Number
17.8
20
NM
RE
[0..1]
Extension
17.9
20
ST
RE
[0..1]
Any Text
22
26
TS
RE
[0..1]
Results Rpt/Status
Change - Date/Time
Date/time the results were reported or status changed.
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
25
1
ID
R
[1..1]
26
745
CM
RE
26.1
623
CE
26.1.1
50
ST
VALUE SET NAME
Result Status (HL7)
table# 123
ELEMENT NAME
DESCRIPTION
Result Status
Status of results for this order.
Corrected Results: A corrected result occurs when a
previously final result report (i.e., an OBR and
associated OBXs where OBR-25 was Final and all
OBX-11s were Final) is being resent with a change to a
value in one or more OBXs.
OBR-25 (Result Status): The status of the entire report
is marked as "C-Corrected" in OBR-25.
OBX-11 (Observation Result Status): The status of
each OBX is marked as either "Final" or "Corrected."
Those OBX values being corrected should have an
OBX-11 status of "C-Corrected." Those OBX values
that remain unchanged should have an OBX-11 status
of "F-Final." A minimum of one OBX must be marked
as corrected.
[0..1]
Parent Result
Field defined to make it available for linkages between
the parent result and its children result. This important
information, together with the information in OBR.29
Parent, uniquely identifies the OBX Segment of the
parent result related to this order.
RE
[0..1]
OBX-3 (Observation
Identifier) of Parent
Result
C
[0..1]
Identifier
Standardized code.
Rule of conditionality: The standard code subcomponent is mandatory unless there is no standard to
match the local value passed by the application. An
attempt will be made by the sender to map the local
value to the standard. In the case that no standard
code was found, this field may be blank.
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
Text
DESCRIPTION
26.1.2
100
ST
O
[0..1]
Standardized description.
26.1.3
199
ID
C
[0..1]
26.1.4
50
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code sub-component
is mandatory if there is no standard to match the local
value passed by the application AND there is no text
present in sub-component 5.
26.1.5
199
ST
C
[0..1]
Alternate Text
Local description. Note that if the field is collected as
text in the application, this may be the only field
populated if the data type is "Coded."
Rule of conditionality: Required if no standardized
code or local code value passed.
26.1.6
20
ID
C
[0..1]
Coding system (HL7) Name of Alternate
table# 0396
Coding System
26.2
20
ST
O
[0..1]
OBX-4 (Sub-ID) of
Parent Result
26.3
100
TX
RE
[0..1]
Part of OBX-5
(Observation Result)
from Parent Result
Coding system (HL7) Name of Coding
table# 0396
System
HL7 identifier for Coding System (e.g. “LN” = LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
The description of the organism from OBX-5, which will
have a data type of "ST" or "TX."
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-8. OBSERVATION REQUEST (OBR) SEGMENT PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
29
511
CM
RE
[0..1]
Parent
Parent ID number.
Field that relates a child to its parent when a parentchild relationship exists.
29.1
255
EI
RE
[0..1]
Placer Order Number
of Parent Result
From ORC-2 (Placer Order Number) or OBR-2 (Placer
Order Number) of parent.
29.1.1
30
ST
R
[1..1]
Entity Identifier
29.1.2
20
IS
RE
[0..1]
Namespace ID
29.1.3
199
ST
RE
[0..1]
Universal ID
Field required to contain an assigning authority OID for
the application/organization responsible for creating
the placer order number. The placer order number is
expected to be unique within this assigning authority.
29.1.4
3
ID
RE
[0..1]
Universal ID Type
Literal value: ‘ISO’.
29.2
255
EI
R
[1..1]
Filler Order Number of From ORC-3 (Filler Order Number) or OBR-3 (Filler
Parent Result
Order Number) of parent.
29.2.1
30
ST
R
[1..1]
Entity Identifier
29.2.2
20
IS
RE
[0..1]
Namespace ID
29.2.3
199
ST
RE
[0..1]
Universal ID
Field required to contain an assigning authority OID for
the application/organization responsible for creating
the filler order number. The filler order number is
expected to be unique within this assigning authority.
29.2.4
3
ID
RE
[0..1]
Universal ID Type
Literal value: ‘ISO’.
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
5.9 OBSERVATION/RESULT (OBX) SEGMENT LEVEL PROFILE
The OBX Segment in the Test Result (ORU) Message is used to transmit observations related to the test result and
other information about patient and specimen, including test result, specimen-related information (such as specimen
IDs from both the test order and the test filler), additional information passed by the test order, etc.
Table 5-9. Observation/Result (OBX) Segment Profile – ORU^R01 Usage
TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
1
4
SI
R
[1..1]
2
3
ID
R
[1..1]
VALUE SET NAME
ELEMENT NAME
Value Type (HL7) table# 125
DESCRIPTION
Set ID - OBX
Sequence number of the OBX in relation to the
OBR Segment to which it refers. The sequence
number should start at 1 and increment by 1 for
each OBX in the Order_Observation group.
Value Type
Field in which allowed values are "CE," "CX,"
"NM," "SN," "ST," "TS" and "TX." The CE data
type is used primarily to convey epidemiologically
important information and coded lab results like
organism name. The CX data type is used
primarily to convey additional specimen
identifiers in OBXs. The NM data type is used to
report a numeric value. The SN data type is
used to report a numeric clinical value with
qualifications. The ST data type is used to
report a short string of text. The TS data type is
used to convey the date/time of illness onset.
The TX data type is used to carry a large text
observation.
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
3
703
CE
R
[1..1]
3.1
50
ST
C
3.2
100
ST
3.3
199
3.4
50
VALUE SET NAME
ELEMENT NAME
Resulted Lab Test Name
(PHLIP Flu) (Composite value
set: values from LOINC and
PLT)
or
PHLIP Questions (Flu)
(Composite value set: values
from LOINC and
PHINQUESTIONS)
DESCRIPTION
Observation
Identifier
Unique identifier for the observation. This field
will be populated by either a resulted test
identifier or an identifier for an observation
related to patient or specimen information (EPI
question).
[0..1]
Identifier
Standardized code.
Rule of conditionality: The standard code
component is mandatory unless there is no
standard to match the local value passed by the
application. An attempt will be made by the
sender to map the local value to the standard.
O
[0..1]
Text
Standardized description.
ID
C
[0..1]
Name of Coding
System
HL7 identifier for Coding System (e.g. “LN” =
LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code component
is mandatory if there is no standard to match the
local value passed by the application AND there
is no text present in component 5.
Coding system (HL7) table#
0396
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
3.5
100
ST
C
[0..1]
3.6
199
ID
C
[0..1]
4
20
ST
CE
[0..1]
5
65536
Varie R
ssee
belo
w
VALUE SET NAME
ELEMENT NAME
Coding system (HL7) table#
0396
[1..*]
DESCRIPTION
Alternate Text
Local description. Note that if the field is
collected as text in the application, this may be
the only field populated if the data type is
"Coded."
Rule of conditionality: Required if no
standardized code or local code value passed.
Not required but recommended to always send
local codes.
Name of Alternate
Coding System
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
Observation Sub-ID
Conditionality Rule: Field required if there is
more than one OBX with the same OBX.3
(Observation Identifier) associated with the same
OBR. Normally, this field is populated with a
number, but text values may also be used.
Observation Value
Actual observation associated with the test order.
The data type in OBX.2 Value Type indicates the
format of the observation.
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TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
5
LEN
703
DT
CE
USA CARDIN
GE
C
ALITY
[0..1]
VALUE SET NAME
ELEMENT NAME
Lab Test Result (PHLIP Flu)
Composite value set: values
from SNOMED CT and PLR)
DESCRIPTION
Observation Value
Rule of conditionality: This data element is
required unless OBX.11 = ‘X’ or ‘N’.
This data type transmits a code and the text
associated with the code.
or
Patient Location Status at
Specimen Collection
(Composite value set:HL7
table# 4 and
PH_HealthcareProviderTaxon
omy_HIPAA)
or
Yes No Unknown (YNU)
Composite value set: values
from Hl7 table#136 and
NullFlavor_HL7_V3
or
Country (ISO_3166-1)
5.1
50
ST
C
[0..1]
Identifier
Standardized code.
Rule of conditionality: The standard code
component is mandatory unless there is no
standard to match the local value passed by the
application. An attempt will be made by the
sender to map the local value to the standard. In
the case that no standard code was found, this
field may be blank.
5.2
100
ST
O
[0..1]
Text
Standardized Description
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
5.3
199
ID
C
[0..1]
5.4
50
ST
C
5.5
100
ST
5.6
199
5
285
VALUE SET NAME
ELEMENT NAME
Coding system (HL7) table#
0396
DESCRIPTION
Name of Coding
System
HL7 identifier for Coding System (e.g. “LN” =
LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code component
is mandatory if there is no standard to match the
local value passed by the application AND there
is no text present in component 5.
C
[0..1]
Alternate Text
Local description. Note that if the field is
collected as text in the application, this may be
the only field populated if the value type is
"Coded."
Rule of conditionality: Required if no
standardized code or local code value passed.
ID
C
[0..1]
Name of Alternate
Coding System
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
CX
R
[1..1]
Observation Value
The CX data type is used to carry the specimen
ID from the filler.
Coding system (HL7) table#
0396
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
5.1
30
ST
R
[1..1]
Specimen ID
The laboratory-generated (local) number that
identifies the specimen related to the test.
Note: PHLIP only supports 1 specimen per
message.
5.4
252
HD
R
[1..1]
Assigning Authority
Entity that assigned the ID.
5.4.1
48
IS
O
[0..1]
Namespace ID
5.4.2
199
ST
R
[1..1]
Universal ID
OID.
5.4.3
3
ID
R
[1..1]
Universal ID Type
Literal value: ‘ISO’.
5
65536
TX
C
[0..1]
Observation Value
Rule of conditionality: This data element is
required unless OBX.11 = ‘X’ or ‘N’.
Field using the TX data type to carry a text result
value. Numeric results and numeric results with
units of measure should not be reported as text.
These should be reported as "NM" or "SN" with
the units of measure in OBX-6. The TX data type
is intended for strings longer than 200 characters.
5.1
65536
TX
R
[1..1]
Text Data
Text observation in the result message.
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TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
5
LEN
36
DT
SN
USA CARDIN
GE
C
ALITY
VALUE SET NAME
[0..1]
ELEMENT NAME
Observation Value
DESCRIPTION
Rule of conditionality: This data element is
required unless OBX.11 = ‘X’ or ‘N’.
Test result in structured numeric format (i.e., an
unambiguous expression of numeric clinical
results along with qualifications). Structured
numeric include intervals (^0^-^1), ratios (^1^/^2
or ^1^:^2), inequalities (<^10), or categorical
results (2^+). The units for the structured
numeric value should be reported in OBX-6.
5.1
2
ST
RE
[0..1]
Comparator
Component that must be one of ‘>‘ or ‘<’ or ‘>=’’
or ‘<=’ or ‘=’ or ‘<>’. If this component is not
valued, it defaults to equal (‘=’).
5.2
15
NM
R
[1..1]
Num1
5.3
1
ST
RE
[0..1]
Separator/Suffix
5.4
15
NM
RE
[0..1]
Num2
5
16
NM
C
[0..1]
Observation Value
Component that must be one of ‘-‘ or ‘+’ or ‘/’’ or
‘.’ or ‘:’.
Rule of conditionality: This data element is
required unless OBX.11 = ‘X’ or ‘N’.
Test result in numeric format.
5.1
16
NM
R
[1..1]
Numeric Data
Number consisting of an optional leading sign (+
or -), the digits, and an optional decimal point. In
the absence of a sign, the number is assumed to
be positive. If there is no decimal point, the
number is assumed to be an integer.
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
5
26
TS
R
[1..1]
Observation Value
Contains the test result as a time stamp. The
date portion of the time stamp follows the rules of
a date field (DT), and the time portion follows the
rules of a time field (TM).
5.1
26
TS
R
[1..1]
Date and Time
Field uses the following format:
YYYY[MM[DD[HHMM]]]
Example: 200707060000 for July 6, 2007, 12:00
a.m.
ST
C
[0..*]
Observation Value
Rule of conditionality: This data element is
required unless OBX.11 = ‘X’ or ‘N’.
5
199
Field using the ST data type to carry a short text
result value. Numeric results and numeric results
with units of measure should not be reported as
text. These should be reported as NM or SN,
with the units of measure in OBX-6.
5.1
199
ST
R
[1..1]
String Data
The ST data type is intended for short strings
(e.g., less than 200 characters).
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Release 1.0.2_r1
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TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
6
LEN
703
DT
CE
USA CARDIN
GE
ALITY
C or
CE?
[0..1]
VALUE SET NAME
ELEMENT NAME
PH_UnitsOfMeasure_UCUM
(subset of UCUM)
DESCRIPTION
Units
Field populated with units of measure if the data
type identified in OBX.2 (and carried in OBX.5) is
""SN." If we use C, then need to explain to use
“1” for any unitless value in OBX.5, for example a
titer.
or
Age Unit Composite value set:
values from UCUM
NullFlavor_HL7_V3)
6.1
50
ST
C
[0..1]
Identifier
Standardized code.
Rule of conditionality: The standard code
component is mandatory unless there is no
standard to match the local value passed by the
application. An attempt will be made by the
sender to map the local value to the standard. In
the case that no standard code was found, this
field may be blank.
6.2
100
ST
O
[0..1]
Text
Standardized description.
6.3
199
ID
C
[0..1]
Name of Coding
System
HL7 identifier for Coding System (e.g. “LN” =
LOINC).
Rule of conditionality: The HL7 coding system
identifier is always required if there is a value in
component 1.
6.4
50
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code component
is mandatory if there is no standard to match the
local value passed by the application AND there
is no text present in component 5.
Coding system (HL7) table#
0396
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APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
6.5
100
ST
C
[0..1]
6.6
199
ID
C
[0..1]
7
60
ST
RE
[0..1]
8
5
ID
RE
[0..1]
VALUE SET NAME
ELEMENT NAME
Coding system (HL7) table#
0396
DESCRIPTION
Alternate Text
Local description. Note that if the field is
collected as text in the application, this may be
the only field populated if the data type is
"Coded."
Rule of conditionality: Required if no
standardized code or local code value passed.
Name of Alternate
Coding System
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
References Range
Interpretation range that applies to the value
reported in OBX-5. It should provide enough
information to understand the abnormal flags
reported in OBX.8.
Abnormal Flag (HL7) table# 78 Abnormal Flags
Indicator of the normalcy of the result found in
OBX.5.
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Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
11
LEN
1
DT
ID
USA CARDIN
GE
R
ALITY
[1..1]
VALUE SET NAME
ELEMENT NAME
Observation Result Status
(HL7) table# 85
Observation Result
Status
DESCRIPTION
Status of the observation result.
Corrected Results: A corrected result occurs
when a previously final result report (i.e., an OBR
and associated OBXs where OBR-25 was "Final"
and all OBX-11s were Final) is being resent with
a change to a value in one or more OBXs.
OBR-25 (Result Status): The status of the entire
report is marked as "C-Corrected" in OBR-25.
OBX-11 (Observation Result Status): The status
of each OBX is marked as either "Final" or
"Corrected." Those OBX values being corrected
should have an OBX-11 status of "C-Corrected."
Those OBX values that remain unchanged
should have an OBX-11 status of "F-Final." A
minimum of one OBX must be marked as
corrected.
OBX-11 = “N” - Not asked; used to affirmatively
document that the observation identified in the
OBX was not sought when the universal service
ID in OBR-4 implies that it would be sought.
OBX-11 = ‘X” - Results cannot be obtained for
this observation
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TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
LEN
DT
USA CARDIN
GE
ALITY
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
14
26
TS
RE
[0..1]
Date/Time of the
Observation
For PHLIP, this field will be used to record the
observation time.
Note: This is a deviation from the HL7 Version
2.3.1 standard, which is the Specimen
Collection Date/Time. In HL7 Version 2.5,
the specimen information has been
expanded. OBX-14 is Specimen Collection
Date/Time; OBX-19 is Date/Time of the
Analysis.
17
354
CE
RE
[0..1]
Observation Method Identifier of the method used to find the result.
Note: For PHLIP, the 1st 3 components are not
supported. The local information will be entered
in the Alternate Text component OBX-17.5.
17.4
50
ST
C
[0..1]
Alternate Identifier
Local code.
Rule of conditionality: The local code component
is mandatory if there is no standard to match the
local value passed by the application AND there
is no text present in component 5.
17.5
100
ST
C
[0..1]
Alternate Text
Local description. Note that if the field is
collected as text in the application, this may be
the only field populated if the data type is
"Coded."
Rule of conditionality: Required if no
standardized code or local code value passed.
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TABLE 5-9. OBSERVATION/RESULT SEGMENT (OBX) PROFILE - ORU^R01 USAGE
SEQ
17.6
LEN
DT
199
ID
USA CARDIN
GE
C
ALITY
[0..1]
VALUE SET NAME
ELEMENT NAME
Coding system (HL7) table#
0396
Name of Alternate
Coding System
DESCRIPTION
Locally defined codes for purpose of sender or
receiver. Local codes can be identified by "L" (for
backward compatibility) or "99zzz" (where z is an
alphanumeric character).
Rule of conditionality: Required if an alternate
identifier is present.
5.10 NOTES AND COMMENTS (NTE) SEGMENT LEVEL PROFILE
The NTE Segment in the test result message can be used to carry comments for the NK1, OBR, and OBX segments.
The NTE segment applies to the entity that immediately precedes it (e.g., order-related comments if it follows the
OBR segment, observation-related comments if it follows the OBX segment).
Table 5-10. Notes and Comments (NTE) Segment Profile – ORU^R01 Usage
TABLE 5-10. NOTES AND COMMENTS SEGMENT (NTE) PROFILE – ORU^R01 USAGE
SEQ
LEN
DT
USAGE
CARDINALITY
1
4
SI
O
[0..1]
2
8
ID
O
[0..1]
3
65536
FT
R
[1..*]
VALUE SET NAME
ELEMENT NAME
DESCRIPTION
Set ID - NTE
Source of Comment
(HL7) table# 105
Source of Comment
HL7 defined values from Table 0105 of the standard ("L" =
Filler, "P" = Placer, "O" = Other)
Comment
This field uses an FT rather than a TX data type. Since
there is no difference between an FT data type without any
embedded formatting commands, and a TX data type, this
change is compatible with previous versions.
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6
PHLIP DATA ELEMENTS OF INTEREST
6.1 COLUMN DEFINITIONS FOR ELEMENTS OF INTEREST TABLE
Column
Description
Program Variables Section
PHIN Variable ID
PHIN element UID drawn from the coding system PH_PHINQuestions_CDC
Label
Short name for the data element, which is passed in the message.
Description
Description of the data element.
Data Type
Data type for the variable response expected by the program area
Prog. Req/Opt
Indicator whether the program specifies the field as:
R - Required - mandatory for sending the message
RE – Required, but may be empty – sender must be able to process (collect/store, display/print etc) this data element and needs
to send data, if information is available, but need not make up “null” values, if information is not available
O - Optional - if the data is available it should be passed
May Rpt
Indicator whether the response to the data element may repeat. “Yes” in the field indicates that it may; otherwise, the field is not
populated. Repeats require special processing.
Value Set Name
Name of the pre-coordinated value set from which the response is drawn. The value sets
and coding systems are accessible via the Public Health Information Network Vocabulary
Access and Distribution Services at http://phinvads.cdc.gov/vads/SearchVocab.action
Message Mapping Methodology Section
Message Context
Specific HL7 segment and field mapping for the element.
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HL7 Data Type
HL7 data type used by PHIN to express the variable.
HL7 Usage
Use of the field for PHIN. Indicates if the field is required, optional, or conditional in a segment. The only values that appear in the
Message Mapping are:
• R – Required. Must always be populated
• O – Optional. May optionally be populated.
HL7 Rpt
Indicator whether the response to the data element may repeat. “Yes” in the field indicates that it may; otherwise, the field is not
populated. Repeats require special processing.
6.2 DATA ELEMENTS OF INTEREST FOR UNSOLICITED RESULTS
The CDC Influenza Epidemiologists have defined the elements listed in the following table as Data Elements of
Interest.
The PHLIP Data Elements of Interest are cross-referenced below to the HL7 context in which the element would be
expressed in the unsolicited result message. Please note that all of the Data Elements of Interest for the unsolicited
result are included, although each site may opt not to send a particular data element that is not a required data
element. R
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eference Key
Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
DEM197
Local
patient ID
The local ID of
the
patient/entity.
Text
DEM115
Birth Date
Reported date
of birth of
patient.
DEM113
Patient’s
sex
DEM162
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
R
PID-3 Patient Identifier List
(Note that the variable ID and
label do not appear in the
message.)
CX
R
Date
RE
PID-7 Date/Time of Birth
(Note that the variable ID and
label do not appear in the
message.)
TS
O
Patient’s current
sex.
Code
O
Administrative Sex
PID-8 Administrative Sex
(Note that the variable ID and
label do not appear in the
message.)
IS
O
Patient
Address
State
Patient’s
address state.
Code
RE
State
PID-11.4 Patient Address State (Note that the variable
ID and label do not appear in
the message.)
ST
O
DEM163
Patient
Address Zip
Code
Patient’s
address zip
code.
Text
RE
PID-11.5 Patient Address Postal Code (Note that the
variable ID and label do not
appear in the message.)
ST
O
DEM165
Patient
Address
County
County of
residence of the
subject.
Code
RE
PID-11.9 Patient Address –
County or
OBX.5 Observation Value
IS
O
County
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
LAB505
Submitting
Laboratory
Name
Name of
organization
collecting
specimen
Text
LAB128
Submitting
Physician
Name
Ordering
Provider
LAB143
Laboratory
ID
Laboratory ID of
the public health
lab sending the
result
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
O
OBR-10 Collector Identifier
(Note that the variable ID and
label do not appear in the
message.)
XCN
O
Text
O
OBR-16 Ordering Provider
(Note that the variable ID and
label do not appear in the
message.)
XCN
O
OID
R
MSH-4.2 Sending FacilityUniversal ID component
(Note that the variable ID and
label do not appear in the
message.)
HD
R
TS
R
MSH-4.3 Universal ID Type.
Literal value: ‘ISO’
LAB163
Collection
Date
Date clinical
specimen was
collected
Date
C
OBR-7 Observation
Date/Time (Note that the
variable ID and label do not
appear in the message.)
Conditionality Rule: If
Receive Date is not
populated, Collection Date
must be present.
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
LAB334
Receive
Date
Date specimen
was received at
public health
laboratory
Date
C
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
OBR-14 Specimen Received
Date/Time (Note that the
variable ID and label do not
appear in the message.)
TS
O
Conditionality Rule: If
Collection Date is not
populated, Receive Date
must be present
LAB165
Specimen
Source
Source of
Specimen
Code
R
Specimen Source
(PHLIP)
OBR-15 Specimen Source
(Note that the variable ID and
label do not appear in the
message.)
CM
O
LAB101
Test
PerformedCode
Test code as
known by the
laboratory
Code
R
Resulted Lab Test
Name (PHLIP Flu)
or
PHLIP Questions
(Flu)
OBX-3 Observation Identifier
(Note that the variable ID and
label do not appear in the
message.)
CE
R
LAB114
Numeric
Result
Value
Test result in
numeric format
Numeric
C
OBX-5 Observation Value
SN
O
LAB192
Coded
Result
Value
Test result as
coded value
Code
C
OBX-5 Observation Value
CE
O
Lab Test Result
(PHLIP Flu)
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
LAB108
Test Date
Date specimen/
isolate was
tested
Date
O
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
OBX-14 Date/Time of
Observation (Note that the
variable ID and label do not
appear in the message.)
TS
O
CX
O
Note: This is a deviation
from HL7 2.3.1 where
this field is the
Collection Date/Time.
LAB202
Specimen
ID
Unique
specimen/
accession/
aliquot ID
assigned by
laboratory-
Code
R
Observation/OBX Segment
with this variable ID and
label.
OBX-2 = CX
OBX-3 = LAB202^Unique
Specimen
ID^PHINQUESTION
OBX-5 = Specimen
ID^^^Assigning Authority
Name&Assigning Authority
ID&Assigning Authority ID
Type
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
21612-7
Reported
Patient Age
Patient’s age as
reported in an
application at
the source
Numeric
with
Units
RE
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
Observation/OBX Segment
with this variable ID and
label.
SN
O
CE
O
OBX-2 = SN
OBX-3 = 21612-7^ Age
Patient Qn Reported^LN
OBX-5 = Age number
OBX-6 = Age units
FLU002
Vaccinated
Was the patient
vaccinated for
Influenza?
Code
O
Yes No Unknown
(YNU)
Observation/OBX Segment
with this variable ID and label
OBX-2 = CE
OBX-3 = FLU002^ Was the
patient vaccinated for
influenza?^ PHINQUESTION
OBX-5 = Y/N
Identifier^Text^HL70136
Or UNK^unknown^ NULLFL
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
FLU001
Antiviral
Medication
Was the patient
receiving
influenza
antiviral
medication?
Code
O
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
Yes No Unknown
(YNU)
Observation/OBX Segment
with this variable ID and label
CE
O
CE
O
OBX-2 = CE
OBX-3 = FLU001^Was the
patient receiving influenza
antiviral
medication?^PHINQUESTIO
N
OBX-5 =
Y/N^Identifier^Text^HL70136
Or UNK^unknown^ NULLFL
LAB514
Outbreak
Related
Was the
specimen
outbreak
related?
Code
O
Yes No Unknown
(YNU)
Observation/OBX Segment
with this variable ID and label
OBX-2 = CE
OBX-3 = LAB514^ Was this
specimen related to an
outbreak?^PHINQUESTION
OBX-5 =
Y/N^Identifier^Text^HL70136
Or UNK^unknown^ NULLFL
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
LAB330
Type of
Facility
Did the
specimen come
from an
outpatient,
inpatient or
long-term care
facility?
Code
O
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
Patient Location
Status at
Specimen
Collection
Observation/OBX Segment
with this variable ID and label
CE
O
OBX-2 = CE
OBX-3 = LAB330^ Patient
location status at specimen
collection (e.g., outpatient,
inpatient, long-term
care).^PHINQUESTION
OBX-5 = I/O/
Identifier^Text^HL70004
Or 282E00000X^Long Term
Care Hospital^ HCPT
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
PHLIP01
Travel
Outside the
US
Did the patient
travel outside
the U.S. within
10 days of
illness onset?
Code
O
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
Yes No Unknown
(YNU)
Observation/OBX Segment
with this variable ID and label
CE
O
OBX-2 = CE
OBX-3 = PHLIP01^Did the
patient travel outside the
U.S. within 10 days of illness
onset?^PHINQUESTION
OBX-5 =
Y/N^Identifier^Text^HL70136
Or UNK^unknown^ NULLFL
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
TRAVEL05
Destination
(s) Traveled
To
International
destination(s)
Code
O
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
Country
Observation/OBX Segment
with this variable ID and label
CE
O
OBX-2 = CE
OBX-3 = TRAVEL05^
International destination(s)
^PHINQUESTION
OBX-5 = Country
Identifier^Text^ISO31661^Local Identifier^Local
Text^Name of Coding
System
Business Rule: Only
applicable if PHLIP01 was
“Yes”.
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
LAB515
Isolate Sent
to CDC
Is Isolate being
sent to CDC?
Code
O
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
Yes No Unknown
(YNU)
Observation/OBX Segment
with this variable ID and label
CE
O
TS
O
OBX-2 = CE
OBX-3 = LAB515^Was
isolate sent to
CDC?^PHINQUESTION
OBX-5 =
Y/N^Identifier^Text^HL70136
Or UNK^unknown^ NULLFL
11368-8
Illness
Onset Date
Date and time of
illness onset
Date
O
Observation/OBX Segment
with this variable ID and label
OBX-2 = TS
OBX-3 = 113688^ILLNESS/INJURY ONSET
DATE/TIME^LN
OBX-5 = Date/time of illness
onset = TS
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Program Specific Data Elements for Unsolicited Results
Variable ID
Label
Description
Data
Type
Prog.
Req/
Opt
LAB517
Isolate ID
Sent to
CDC
Laboratory ID
assigned to the
isolate sent to
the CDC
Code
O
May
Rpt
Mapping Methodology
Value Set Name
Message Context
HL7
Data
Type
HL7
Usage
Observation/OBX Segment
with this variable ID and label
CX
O
TX
O
OBX-2 = CX
OBX-3 = LAB517^Identifier
assigned by laboratory to the
isolate sent to
CDC^PHINQUESTION
OBX-5 = Isolate
ID^^^Assigning Authority
Name&Assigning Authority
ID&Assigning Authority ID
Type
PHLIP02
Passage
History
History of
Culture Medium
Text
O
Observation/OBX segment
with this variable ID and label
OBX-2 = TX
OBX-3 = PHLIP02^History of
culture medium
^PHINQUESTION
OBX-5 = Passage History
Text Description
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7
SAMPLE MESSAGE
7.1 STORYBOARD
Dr. Marcus Welby, Jr., sees Jared Doe, Jr., a 30-year-old male, during an office visit.
Jared Doe presents symptoms of fever, cough, sore throat and muscle aches, all
consistent with a diagnosis of influenza. While examining the patient, Dr. Welby
discovers that Mr. Doe has been traveling outside of the United States recently,
specifically Italy, West Africa, and Bangkok. Dr. Welby decides to order an Influenza
Identification Test from his local public health department to determine the type of
influenza virus the patient has acquired.
A sputum sample is taken from the patient, and an electronic order for the testing is
placed through Dr. Welby's EHR application, a Northeast Medical Center ordering
application. The Northeast Medical Center ordering application transmits the order to
the Virginia State STARLIMS application for processing. Dr. Welby sends the patient
home, prescribing bed rest, plenty of fluids and an anti-inflammatory, such as
ibuprofen or aspirin.
7.1.1 SAMPLE
MSH|^~\&|VA STARLIMS Stage^2.16.840.1.114222.4.3.3.2.2.1^ISO|VA PHL
Richmond^2.16.840.1.114222.4.1.9977^ISO|US WHO Collab
LabSys^2.16.840.1.114222.4.3.3.7^ISO|CDC EPI Surv
Branch^2.16.840.1.114222.4.1.10416^ISO|200707071830||ORU^R01|200707070897|P|2.3.1
|||||||||PHLIP_ORU_v1.0.2^PHIN_Profile_ID^2.16.840.1.114222.4.10.3^ISO
PID|1||105431122VA^^^VA STARLIMS_Stage&2.16.840.1.114222.4.3.3.2.2.1&ISO^MR^VA PHL
Richmond&2.16.840.1.114222.4.1.9977&ISO||Doe^Jared^Q^Jr^^BBA^L||19760909|M||21063^White^CDCREC~2028-9^Asian^CDCREC|2166 Wells
Dr^AptB^Richmond^51^23235^US^H|||||||||||2186-5^Not Hispanic or Latino^CDCREC^N^Not
Hispanic^L||||||||N
ORC|RE|NE5400123^NE Med System^2.16.840.1.114222.75.9.1.2.1^ISO|F67993405^VA STARLIMS
Stage^2.16.840.1.114222.4.3.3.2.2.1^ISO||CM||||||||||||||||Northeast Medical
Center|1600 Hospital Drive^Ste
350^Richmond^51^23235^US^M|^WPN^PH^^^804^6486154^320~^NET^X.400^jsmith@neastmed.com
OBR|1|NE5400123^NE Med System^2.16.840.1.114222.75.9.1.2.1^ISO|F67993405^VA STARLIMS
Stage^2.16.840.1.114222.4.3.3.2.2.1^ISO|PLT40^Epidemiologically Important Information Influenza^PLT|||200706270930|||||||200706271530|SPT&Sputum&
HL70070&SPU&Sputum&L|^Welby^Marcus^J^Jr^Dr^MD|||||||||F
OBX|1|SN|21612-7^Age Patient Qn Reported^LN||^30|a^year^UCUM|||||F
OBX|2|CE|FLU002^Was the patient vaccinated for
Influenza?^PHINQUESTION||Y^Yes^HL70136||||||F
OBX|3|CE|FLU001^Was the patient receiving influenza antiviral
medication?^PHINQUESTION||N^No^HL70136||||||F
OBX|4|CE|LAB514^Was this specimen related to an outbreak?^PHINQUESTION||Y^Yes^
HL70136||||||F
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OBX|5|CE|LAB330^Patient location status at specimen collection (e.g., outpatient,
inpatient, long-term care)^PHINQUESTION||O^Outpatient^HL70489||||||F
OBX|6|CE|PHLIP01^Did the patient travel outside the U.S. within 10 days of illness
onset?^PHINQUESTION||Y^Yes^HL70136||||||F
OBX|7|CE|TRAVEL05^International destination(s)^PHINQUESTION||IT^Italy^ISO31661~^^^WTAF^West Africa^L~^^^BANT^Bangkok^L||||||F
OBX|8|CE|LAB515^Is Isolate being sent to CDC?^PHINQUESTION||Y^Yes^ HL70136||||||F
OBX|9|TS|11368-8^ILLNESS/INJURY ONSET DATE/TIME^LN||20070622||||||F
OBX|10|CX|LAB517^Identifier assigned by laboratory to the isolate sent to
CDC^PHINQUESTION||A16170^^^VA
STARLIMS_Stage&2.16.840.1.114222.4.3.3.2.2.1&ISO||||||F
OBX|11|TX|PHLIP02^History of culture medium^PHINQUESTION||E1 One Time in Egg||||||F
OBX|12|IS|DEM165^Patient Address County^PHINQUESTION||Prince William||||||F
OBR|2|NE5400123^NE Med System^2.16.840.1.114222.75.9.1.2.1^ISO|F67993405^VA STARLIMS
Stage^2.16.840.1.114222.4.3.3.2.2.1^ISO|PLT77^Influenza Virus Detection and
Identification^PLT|||200706270930|||||||200706271530|SPT&Sputum&HL70070&CSW&Cheek
Swab&L|^Welby^Marcus^J^Jr^Dr^MD|||||||||F
OBX|1|CX|LAB202^Unique Specimen ID^PHINQUESTION||VA12345^^^VA STARLIMS
Stage&2.16.840.1.114222.4.3.3.2.2.1&ISO||||||F
OBX|2|CE|22827-0^FluAV subtype XXX PCR^LN||PLR67^Influenza A H5 asian lineage
detected^PLR|||A|||F|||200707011422
Page 73
APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
HL7 V2.3.1 Messaging Guide for Influenza Test Result Reporting
Release 1.0.2_r1
INFLUENZA TEST RESULT REPORTING BY PUBLIC HEALTH LABORATORIES
8
MISCELLANEOUS
8.1 APPLICATION & ORGANIZATIONAL OIDS
List of current organizational and application OIDs for use in this project can be found in the
Production documents folder on sharepoint:
Lab messaging OIDs- Facs, Apps, PHINMS.xlsx
8.2 LINK TO HL7 TABLE 396 – CODING SYSTEMS
HL7 Table 0396
8.3 LINK TO PHINVADS
PHIN Vocabulary Access and Distribution System
Page 74
APHL-CDC Public Health Laboratory Interoperability Project (PHLIP)
HL7 V2.3.1 Messaging Guide for Influenza Test Result Reporting
Release 1.0.2_r1
| File Type | application/pdf |
| File Title | Microsoft Word - HL7v2_3_1_APHL_Influenza_Msg_Guide_ORU_v1.0.2_r1.doc |
| Author | Ulrike Merrick |
| File Modified | 2010-11-02 |
| File Created | 2010-06-20 |