Table of contents
- Original Document Notification with Content (MDM-T02) Outbound Specifications
- Basic Interface Structure and Description
- MSH Segment - Message Header
- PID Segment - Patient Identification
- TXA Segment - Document Notification
- PV1 Segment – Patient Visit
- OBX – Observation Result Segment
- First OBX
- Second OBX
- Third OBX
- Fourth OBX
- Fifth OBX
- Sixth OBX
- Seventh OBX
- Eighth OBX
- Ninth OBX
- Tenth Through Second-to-Last OBX
- Last OBX
- Example URL:
- Note 1.1:
- Sample OBX segment (Encapsulated Data):
Original Document Notification with Content (MDM-T02) Outbound Specifications
IRIS can send results to your EMR as an MDM message. By far, most EMR/EHR systems prefer an ORU result but in cases where your workflow is better suited to an MDM this can be used.
Basic Interface Structure and Description
This document outlines the values sent in an HL7 results message (MDM-T02) from IRIS to a third-party system. This third-party system could be another application, an interface engine, or an EMR. For the purposes of this documentation, this third-party will be referred to an EMR.
The following sections contain details of the MDM message content by HL7 Segment.
MSH Segment - Message Header
The message header segment includes information that defines the structure of the message.
Sample MSH segment:
MSH|^\~\&|IRIS|IRIS|VENDOR|VENDOR|20170410145907||MDM^T02|170410145907|T|2.4
| Field | Name and type | Sample value | Description | |
|---|---|---|---|---|
| MSH-1 | Field Separator (ST) | Auto generated | ||
| MSH-2 | Encoding Characters (ST) | ^~\& | Auto generated | |
| MSH-3 | Sending Application (HD) | IRIS | “IRIS” is used as the default value | |
| MSH-4 | Sending Facility (HD) | IRIS | “IRIS” is used as the default value | |
| MSH-5 | Receiving Application (HD) | VENDOR | The name of the EMR. This need to be pre-defined | |
| MSH-6 | Receiving Facility (HD) | VENDOR | The name or id of clinic. This need to be pre-defined. | |
| MSH-7 | Date/Time of Message (TS) | yyyyMMddHHmmss format, e.g. “20190410145907” | Auto generated based off server time (UTC if hosted by IRIS) | |
| MSH-8 | Security (ST) | Empty | ||
| MSH-9 | Message Type (MSG) | MDM^T02 | Unchanging | |
| MSH-10 | Message Control ID (ST) | 190410145907 | Auto generated from server time (UTC if hosted by Iris) | |
| MSH-11 | Processing ID (PT) | T | P (Production) or T (Test) will be used based on the system environment | |
| MSH-12 | Version ID (VID) | 2.4 | HL7 Version |
PID Segment - Patient Identification
The patient identification segment will include patient-specific demographic information.
Sample PID segment:
PID||ITCC20170410^^^^MRN|ITCC20170410||DOE^JOHN||19581012|M||||||||||1234|111-22-3333
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| PID-1 | Set ID - PID (SI) | Empty by default | |
| PID-2 | Patient ID (CX) | ITCC20170410^^^^MRN | |
| PID-2.1 ID | ITCC20170410 | Related Patient’s MRN value | |
| …. | PID-2.2 through PID-2.4 empty by default | ||
| PID-2.5 Identifier Type Code | MRN | Related Patient’s ID type if requested | |
| PID-3 | Patient Identifier List (CX) | ITCC20170410 | Reflects the same value as PID-2.1 by default |
| PID-4 | Alternate Patient ID - PID (CX) | Empty by default | |
| PID-5 | Patient Name (XPN) | DOE^JOHN | Related Patient’s family name &given name |
| PID-6 | Mother’s Maiden Name (XPN) | Empty by default | |
| PID-7 | Date/Time of Birth (TS) | 19581012 | Related Patient’s Date of birth; YYYYMMDD format |
| PID-8 | Administrative Sex (IS) | M | Related patient’s sex (M or F) |
| PID-9 | Patient Alias (XPN) | Empty by default | |
| PID-10 | Race (CE) | Empty by default | |
| PID-11 | Patient Address (XAD) | Empty by default | |
| PID-12 | County Code (IS) | Empty by default | |
| PID-13 | Phone Number - Home (XTN) | Empty by default | |
| PID-14 | Phone Number - Business (XTN) | Empty by default | |
| PID-15 | Primary Language (CE) | Empty by default | |
| PID-16 | Marital Status (CE) | Empty by default | |
| PID-17 | Religion (CE) | Empty by default | |
| PID-18 | Patient Account Number (CX) | 1234 | Related Patient’s CSN/Account value/Encounter number |
| PID-19 | SSN Number - Patient (ST) | 111-22-3333 | Iris does not store SSN |
TXA Segment - Document Notification
Document identification
Sample TXA Segment
TXA|1|92250^Retinal Imaging w Interpretation||200901151010||||||GR0001^DOE^JANE^^MD^DR^^^^^^^NPI||442B30D3-C963-434E-8886-3735CED1C5E8||124566|||F|
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| TXA-1 | Set ID - TXA (SI) | 1 | Always 1 |
| TXA-2.1 | Identifier | 92250 | Procedure Code |
| TXA-2.2 | Document description | Retinal Imaging w Interpretation | Procedure Code Description |
| TXA-4 | Date/Time | 200901151010 | Julian Date time |
| TXA-10.1 | Assigned Document Authenticator (ADA) Person Id | 0123456789 | Ordering Provider Id (NPI) |
| TXA-10.2 | ADA Family Name | DOE | Ordering Provider Last name |
| TXA-10.3 | ADA Given Name | JANE | Ordering Provider First name |
| TXA-10.5 | ADA Name Suffix | MD | Ordering Provider Name Suffix |
| TXA-10.6 | ADA Name Prefix | DR | Ordering Provider Name Prefix |
| TXA-10.13 | ADA Identifier type | NPI | Ordering Provider Id type |
| TXA-12 | Unique Doc Number | 442B30D3-C963-434E-8886-3735CED1C5E8 | Unique identifier for this document |
| TXA-14 | Placer Order Number | 124566 | Order Number as originally created by EMR |
| TXA-17 | Document Completion Status | F | Result report status ((F)inal, (C)orrection) |
PV1 Segment – Patient Visit
The patient visit segment includes patient-specific visit information.
Sample PV1 segment:
PV1|1|O|POC01||||GR0001^DOE^JANE^^^MD^MD^^^^^^NPI|OP0001^DOE^JACK^^^MD^M D^^^^^^NPI|||||||||GR0001^DOE^JANE^^^MD^MD^^^^^^NPI|||||||||||||||||||||||||||20170410145803|20170410145803
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| PV1-1 | Set ID - PV1 (SI) | 1 | Always 1 |
| PV1-2 | Patient Class (IS) | O | Always “O” (for outpatient) |
| PV1-3 | Assigned Patient Location (PL) | POC01 | Point of care information; received from the ORM HL7 message |
| PV1-4 | Admission Type (IS) | Empty by default | |
| PV1-5 | Preadmit Number (CX) | Empty by default | |
| PV1-6 | Prior Patient Location (PL) | Empty by default | |
| PV1-7 | Attending Doctor (XCN) | OP0001^DOE^JACK^^ ^MD^MD^^^^^^NPI | This reflects the ordering provider received in the ORM HL7 message |
| PV1-7.1 ID | OP0001 | Reflects the ORM HL7 messageORC-12.1 value | |
| PV1-7.2 Family Name | DOE | Reflects the ORM HL7 messageORC-12.2 value | |
| PV1-7.3 Given Name | JANE | Reflects the ORM HL7 messageORC-12.3 value | |
| ….. | PV1-7.4 & PV1-7.5 empty by default | ||
| PV1-7.5 Prefix | MD | Credentials of the ordering physician if available | |
| PV1-7.6 Degree | MD | Credentials of the ordering physician if available | |
| ….. | PV1-7.7 through PV1-7.12 Empty by default | ||
| PV1-7.13 Identifier Type Code | NPI | Provider type identifying code; typically “NPI” | |
| PV1-8 | Referring Doctor (XCN) | OP0001^DOE^JACK^^ ^MD^MD^^^^^^NPI | This reflects the ordering provider received in the ORM HL7 message |
| PV1-8.1 ID | OP0001 | Reflects the ORM HL7 messageORC-12.1 value | |
| PV1-8.2 Family Name | DOE | Reflects the ORM HL7 messageORC-12.2 value | |
| PV1-8.3 Given Name | JACK | Reflects the ORM HL7 messageORC-12.3 value | |
| ….. | PV1-8.4 & PV1-8.5 empty by default | ||
| PV1-8.5 Prefix | MD | Credentials of the ordering physician if available | |
| PV1-8.6 Degree | MD | Credentials of the ordering physician if available | |
| ….. | PV1-8.7 through PV1-8.12 Empty by default | ||
| PV1-8.13 Identifier Type Code | NPI | Provider type identifying code; typically “NPI” | |
| PV1-10 | Hospital Service (IS) | Empty by default | |
| PV1-11 | Temporary Location (PL) | Empty by default | |
| PV1-12 | Preadmit Test Indicator (IS) | Empty by default | |
| PV1-13 | Re-admission Indicator (IS) | Empty by default | |
| PV1-14 | Admit Source (IS) | Empty by default | |
| PV1-15 | Ambulatory Status (IS) | Empty by default | |
| PV1-16 | VIP Indicator (IS) | Empty by default | |
| PV1-17 | Admitting Doctor (XCN) | OP0001^DOE^JACK^^ ^MD^MD^^^^^^NPI | This reflects the ordering provider received in the ORM HL7 message |
| PV1-17.1 ID | OP0001 | Reflects the ORM HL7 messageORC-12.1 value | |
| PV1-17.2 Family Name | DOE | Reflects the ORM HL7 messageORC-12.2 value | |
| PV1-17.3 Given Name | JANE | Reflects the ORM HL7 messageORC-12.3 value | |
| ….. | PV1-17.4 & PV1-17.5 empty bydefault | ||
| PV1-17.5 Prefix | MD | Credentials of the ordering physician if available | |
| PV1-17.6 Degree | MD | Credentials of the ordering physician if available | |
| ….. | PV1-17.7 through PV1-17.12 Empty by default | ||
| PV1-17.13 Identifier Type Code | NPI | Provider type identifying code; typically “NPI” | |
| PV1-18 | Patient Type (IS) | Empty by default | |
| PV1-19 | Visit Number (CX) | Related Patient’s CSN/Account value/Encounter number | |
| PV1-20 | Financial Class (FC) | Empty by default | |
| PV1-21 | Charge Price Indicator (IS) | Empty by default | |
| PV1-22 | Courtesy Code (IS) | Empty by default | |
| PV1-23 | Credit Rating (IS) | Empty by default | |
| PV1-24 | Contract Code (IS) | Empty by default | |
| PV1-25 | Contract Effective Date (DT) | Empty by default | |
| PV1-26 | Contract Amount (NM) | Empty by default | |
| PV1-27 | Contract Period (NM) | Empty by default | |
| PV1-28 | Interest Code (IS) | Empty by default | |
| PV1-29 | Transfer to Bad Debt Code (IS) | Empty by default | |
| PV1-30 | Transfer to Bad Debt Date (DT) | Empty by default | |
| PV1-31 | Bad Debt Agency Code (IS) | Empty by default | |
| PV1-32 | Bad Debt Transfer Amount (NM) | Empty by default | |
| PV1-33 | Bad Debt Recovery Amount (NM) | Empty by default | |
| PV1-34 | Delete Account Indicator (IS) | Empty by default | |
| PV1-35 | Delete Account Date (DT) | Empty by default | |
| PV1-36 | Discharge Disposition (IS) | Empty by default | |
| PV1-37 | Discharged to Location (DLD) | Empty by default | |
| PV1-38 | Diet Type (CE) | Empty by default | |
| PV1-39 | Servicing Facility (IS) | Empty by default | |
| PV1-40 | Bed Status (IS) | Empty by default | |
| PV1-41 | Account Status (IS) | Empty by default | |
| PV1-42 | Pending Location (PL) | Empty by default | |
| PV1-43 | Prior Temporary Location (PL) | Empty by default | |
| PV1-44 | Admit Date/Time (TS) | yyyyMMddHHmmss format | Date of image captured |
| PV1-45 | Discharge Date/Time (TS) | yyyyMMddHHmmss format | Date of image captured |
| PV1-46 | Current Patient Balance (NM) | Empty by default | |
| PV1-47 | Total Charges (NM) | Empty by default | |
| PV1-48 | Total Adjustments (NM) | Empty by default | |
| PV1-49 | Total Payments (NM) | Empty by default | |
| PV1-50 | Alternate Visit ID (CX) | Empty by default | |
| PV1-51 | Visit Indicator (IS) | Empty by default | |
| PV1-52 | Other Healthcare Provider (XCN) | Empty by default |
OBX – Observation Result Segment
OBX contains the document content. It is used to transmit a single observation or observation fragment. OBX segments can repeat and each one contains following information.
IRIS’ default OBX configuration contains the discrete results in the first 9 OBX segments, followed by the textual portion of the result findings, and then the document modality. The breakdown follows this configuration (the numbers refer to the Set ID): OBX 1 contains the overall severity for discrete findings of both eyes, OBX 2-5 contain details of the right eye, OBX 6-9 contain details of the left eye, OBX 10-30 grading results, and the last OBX is where either an encoded PDF or pointer link (static URL) is sent.
Sample Discrete Results (Default):
OBX|1|ST|SEVERITY^^IRIS|1|NORMAL||||||F
OBX|2|ST|RIGHTDIABRETIN^^IRIS|2|None||||||F
OBX|3|ST|RIGHTMACEDEMA^^IRIS|3|None||||||F
OBX|4|ST|RIGHTOTHERRETIN^^IRIS|4|None||||||F
OBX|5|ST|RIGHTQUALAPP^^IRIS|5|Gradable Image||||||F
OBX|6|ST|LEFTDIABRETIN^^IRIS|6|None||||||F
OBX|7|ST|LEFTMACEDEMA^^IRIS|7|None||||||F
OBX|8|ST|LEFTOTHERRETIN^^IRIS|8|None||||||F
OBX|9|ST|LEFTQUALAPP^^IRIS|9|Gradable Image||||||F
Sample Discrete Results with Alternating OBX/NTE segments (Secondary Option):
OBX|1|ST|^^IRIS|1|NORMAL|||
NTE|1|ST|SEVERITY
OBX|2|ST|^^IRIS|2|None||||||F
NTE|1|ST|RIGHTDIABRETIN
OBX|3|ST|^^IRIS|3|None||||||F
NTE|1|ST|RIGHTMACEDEMA
OBX|4|ST|^^IRIS|4|None||||||F
NTE|1|ST|RIGHTOTHERRETIN
OBX|5|ST|RIGHTQUALAPP^^IRIS|5|Gradable Image||||||F
OBX|6|ST|^^IRIS|6|None||||||F
NTE|1|ST|LEFTDIABRETIN
OBX|7|ST|^^IRIS|7|None||||||F
NTE|1|ST|LEFTMACEDEMA
OBX|8|ST|^^IRIS|8|None||||||F
NTE|1|ST|LEFTOTHERRETIN
OBX|9|ST|LEFTQUALAPP^^IRIS|9|Gradable Image||||||F
First OBX
Severity section
Sample OBX segment: First OBX
OBX|1|ST|SEVERITY^^IRIS|1|NORMAL||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 1 | Increases sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | The literal value “ST” (i.e. String for OBX-5) |
| OBX-3 | Observation Identifier (CE) | SEVERITY^^IRIS | |
| OBX-3.1 Identifier | SEVERITY | The literal value “SEVERITY” | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | The literal value “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 1 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | CRITICAL | One of three values based on the result findings: NORMAL, ALERT, or CRITICAL |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | AA | One of three values based on the result findings: empty (Normal), A (ALERT), or AA (CRITICAL) |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F | F = Final, C = Corrected* |
Second OBX
Sample OBX segment:
OBX|2|ST|RIGHTDIABRETIN^^IRIS|2|None||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 2 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | Always “ST” (i.e. String for OBX- 5) |
| OBX-3 | Observation Identifier (CE) | RIGHTDIABRETIN^^IRIS | |
| OBX-3.1 Identifier | RIGHTDIABRETIN | Always “RIGHTDIABRETIN”; stands for RIGHT eye diabetic retinopathy | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | Always “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 2 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | None | One of three values based on the result findings: None, Mild, Moderate, Severe, or Proliferative |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | One of three values based on the result findings: empty (Normal), A (ALERT), or AA (CRITICAL) | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F | F = Final, C = Corrected* |
Third OBX
Sample OBX segment: Third
OBX|3|ST|RIGHTMACEDEMA^^IRIS|3|Severe|||AA|||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 3 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | Always “ST” (i.e. String for OBX- 5) |
| OBX-3 | Observation Identifier (CE) | RIGHTMACEDEMA^^IRIS | |
| OBX-3.1 Identifier | RIGHTMACEDEMA | Always “RIGHTMACEDEMA”; stands for RIGHT eye macular edema | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | Always “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 3 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | Severe | One of three values based on the result findings: None, Mild, Moderate, or Severe |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | AA | One of three values based on the result findings: empty (Normal), A (ALERT), or AA (CRITICAL) |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F | F = Final, C = Corrected* |
Fourth OBX
Sample OBX segment:
OBX|4|ST|RIGHTOTHERRETIN^^IRIS|4|None||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 4 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | Always “ST” (i.e. String for OBX- 5) |
| OBX-3 | Observation Identifier (CE) | RIGHTOTHERRETIN^^IRIS | |
| OBX-3.1 Identifier | RIGHTOTHERRETIN | Always “RIGHTOTHERRETIN”; stands for RIGHT eye OTHER retinopathy | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | Always “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 4 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | None, Suspected Glaucoma, Suspected Dry AMD, Suspected Wet AMD, Suspected Vein Occlusion, Suspected HTN Retinopathy, Suspected Epiretinal Membrane, Suspected Macular Hole, Suspected Cataracts, Suspected Geographic Atrophy, Other based on result. | Providers can choose to apply a predefined description (see Sample Value) or populate with a free-text note |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | One of three values based on the result findings: empty (Normal), or A (ALERT) | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F |
Fifth OBX
Sample OBX segment:
OBX|5|ST|RIGHTQUALAPP^^IRIS|5|Gradeable Image||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 5 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | Always “ST” (i.e. String for OBX- 5) |
| OBX-3 | Observation Identifier (CE) | RIGHTQUALAPP^^IRIS | |
| OBX-3.1 Identifier | RIGHTQUALAPP | Always “RIGHTQUALAPP”; stands for RIGHT eye image quality. | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | Always “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 5 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | Gradable Image | Either “Gradable Image” or “Not Gradable Image” based on the image quality |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | Empty by default | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F |
Sixth OBX
Sample OBX segment:
OBX|6|ST|LEFTDIABRETIN^^IRIS|6|Proliferative|||AA|||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 6 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | Always “ST” (i.e. String for OBX- 5) |
| OBX-3 | Observation Identifier (CE) | LEFTDIABRETIN^^IRIS | |
| OBX-3.1 Identifier | LEFTDIABRETIN | Always “LEFTDIABRETIN”; stands for LEFT eye diabetic retinopathy | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | Always “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 6 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | Proliferative | One of three values based on the result findings: None, Mild, Moderate, Severe, or Proliferative |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | AA | One of three values based on the result findings: empty (Normal), A (ALERT), or AA (CRITICAL) |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F | F = Final, C = Corrected* |
Seventh OBX
Sample OBX segment: Seventh OBX
OBX|7|ST|LEFTMACEDEMA^^IRIS|7|None||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 7 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | Always “ST” (i.e. String for OBX- 5) |
| OBX-3 | Observation Identifier (CE) | LEFTMACEDEMA^^IRIS | |
| OBX-3.1 Identifier | LEFTMACEDEMA | Always “LEFTMACEDEMA”; stands for LEFT eye macular edema | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | Always “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 7 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | None | One of three values based on the result findings: None, Mild, Moderate, or Severe |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | One of three values based on the result findings: empty (Normal), A (ALERT), or AA (CRITICAL) | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F | F = Final, C = Corrected* |
Eighth OBX
Sample OBX segment:
OBX|8|ST|LEFTOTHERRETIN^^IRIS|8|None||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 8 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | Always “ST” (i.e. String for OBX-5) |
| OBX-3 | Observation Identifier (CE) | LEFTOTHERRETIN^^IRIS | Empty by default |
| OBX-3.1 Identifier | LEFTOTHERRETIN | Always “LEFTOTHERRETIN”. Identify this OBX as a Left eye other retinopathy. | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | Always “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 8 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | None, Suspected Glaucoma, Suspected Dry AMD, Suspected Wet AMD, Suspected Vein Occlusion, Suspected HTN Retinopathy, Suspected Epiretinal Membrane, Suspected Macular Hole, Suspected Cataracts, Suspected Geographic Atrophy, Other based on result. | Providers can choose to apply a predefined description (see Sample Value) or populate with a free-text note |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | One of three values based on the result findings: empty (Normal), or A (ALERT) | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F |
Ninth OBX
Sample OBX segment:
OBX|9|ST|LEFTQUALAPP^^IRIS|9|Gradeable Image||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 9 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ST | Always “ST” (i.e. String for OBX- 5) |
| OBX-3 | Observation Identifier (CE) | LEFTQUALAPP^^IRIS | |
| OBX-3.1 Identifier | LEFTQUALAPP | Always “LEFTQUALAPP”; stands for LEFT eye image quality | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | IRIS | Always “IRIS” | |
| OBX-4 | Observation Sub-Id (ST) | 9 | Sequential counter that matches the Set ID |
| OBX-5 | Observation Value (Varies) | Gradable Image | Either “Gradable Image” or “Not Gradable Image” based on the image quality |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | Empty by default | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F |
Tenth Through Second-to-Last OBX
Sample OBX segment (default):
OBX|10|FT|Result^^IRIS|001|Retinal Study Result for DOE, JOHN||||||F
OBX|11|FT|Result^^IRIS|002|||||||F
OBX|12|FT|Result^^IRIS|003|DOE, JOHN, a 58 y/o, M (DOB: 10-12-1958, MRN:ITCC20170410)||||||F
OBX|28|FT|Result^^IRIS|019|This result was electronically signed by DOE, JANE, MD on 04-102017 09:59:02 UTC time.||||||F
OBX|29|FT|Result^^IRIS|020|||||||F
OBX|30|FT|Result^^IRIS|021|NOTE: Any pathology noted on this diabetic retinal evaluation should be confirmed by an appropriate ophthalmic examination.||||||F
Secondary Option (Single OBX): Iris can send the text results can be sent in a single OBX segment
Tertiary Option (NTE Segments): Iris can send the text results as NTE segments instead of OBX segments
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 10 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | FT | Formatted Text, but can be defined differently like “ST” if necessary |
| OBX-3 | Observation Identifier (CE) | Result^^IRIS | |
| OBX-3.1 Identifier | Result | “Result” but can be defined with other value if necessary | |
| OBX-3.2 Text | Usually be empty but can be defined with any value if necessary | ||
| OBX-3.3 Name of Coding System | IRIS | “IRIS” is used as the default value | |
| OBX-4 | Observation Sub-Id (ST) | 001 | Grading specific identifier; this number increases sequentially by 1 for each additional OBX segment |
| OBX-5 | Observation Value (Varies) | All the text from the Iris report will be displayed here on its own OBX line. Carriage returns will also receive their own OBX segment. | |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | Empty by default | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F |
Last OBX
Reference Pointer Option
Sample OBX segment:
OBX|31|RP|LINK^^PDFLINK|31|https://api.retinalscreenings.com/api/PatientOrders/GetSingleResultForDisplayInEmr?patientOrderId=273013&asPdf=True&isPreliminary=False&auth=257805B4B262A18271B60A62026671703D0F3F335DC9E0643662358952E7DCBA19C1C2CCC6C781A3444D651C0AC6695750DA87C9A5CE0F5976E8A206D9FB1915||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 31 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | RP | Reference Pointer (RP): used when a pointer URL is configured |
| OBX-3 | Observation Identifier (CE) | ||
| Reference Pointer (RP) Configuration | LINK^^PDFLINK | This is the default delivery method | |
| OBX-3.1 Identifier | LINK | “LINK” is the default value | |
| OBX-3.2 Text | Empty by default | ||
| OBX-3.3 Name of Coding System | PDFLINK | “PDFLINK” is used as the default value | |
| OBX-4 | Observation Sub-Id (ST) | 31 | Sequential counter that corresponds with the Set ID |
| OBX-5 | Observation Value (Varies) | This is a link to the PDF stored in Iris | |
| OBX-5.1 Reference Pointer | See Note 1.0 Below | See Note 1.1 Below | |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | Empty by default | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F |
Note 1.0:
Example URL:
https://api.retinalscreenings.com/api/PatientOrders/GetSingleResultForDisplayInEmr?patientOrderId=12345&asPdf=True&isPreliminary=False&auth=xxxxx
Note 1.1:
IRIS will populate “&” as a value instead of HL7 standard value “\T" for client. Upon request, IRIS can populate “\T\” instead of”8”. Example:
o “…?patientOrderId=273013\T\asPdf…” to “…?patientOrderId=273013&asPdf…”
Patient MRN is displayed here:
o patientOrderId=12345
Document type:
o aspdf=True
Document status (will always be set to False)
o isPreliminary=False
Document pointer
o auth=xxxxx
Sample OBX segment (Encapsulated Data):
OBX|27|ED|||PDF^TEXT^^Base64^[ Base64 Encoded PDF]||||||F
| Field | Name and type | Sample value | Description |
|---|---|---|---|
| OBX-1 | Set ID - OBX (SI) | 27 | Increase sequentially by 1 |
| OBX-2 | Value Type (ID) | ED | Encapsulated Data (ED): used when an encoded PDF is configured; this configuration can be used in addition to or in lieu of the RP configuration |
| OBX-3 | Observation Identifier (CE) | Empty by default | |
| OBX-4 | Observation Sub-Id (ST) | Empty by default | |
| OBX-5 | Observation Value (Varies) | ||
| Encapsulated Data (ED) | PDF^TEXT^^Base64^[Base64 Encoded PDF] | ||
| OBX-5.1 Source application | This is the document type | ||
| OBX-5.2 Type of data | TEXT | “TEXT” is the default value | |
| OBX-5.3 Data subtype | Empty by default | ||
| OBX-5.4 Encoding | Base64 | Always “Base64” which matches the encoding | |
| OBX-5.4 Data (ST) | See Note 2.0 Below | Actual PDF data using base64 encoding mechanism | |
| OBX-6 | Units (CE) | Empty by default | |
| OBX-7 | References Range (ST) | Empty by default | |
| OBX-8 | Abnormal Flags (IS) | Empty by default | |
| OBX-9 | Probability (NM) | Empty by default | |
| OBX-10 | Nature of Abnormal Test (ID) | Empty by default | |
| OBX-11 | Observation Result Status (ID) | F | F = Final, C = Corrected* |