Standard Results (ORU-R01) Outbound Specifications

Interface content encoding for results from IRIS v3.x to HL7 Integration Engines

Table of contents

Basic Interface Structure and Description

This document outlines the values sent in an HL7 results message (ORU-R01) 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.

Following this section, the rest of the document will be divided by HL7 segment types as they would appear in a delivered HL7 message. IRIS has two different methods for delivering the document in an OBX segment: encoded PDF or pointer link (static URL). This will be described in detail later in that section. The last section of this document contains an example HL7 message.

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||ORU^R01|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) ORU^R01 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

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 by default
  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

ORC – Common Order

The Common Order segment is used to transmit fields that are common to all orders. The ORC segment is required in the Order (ORM) message.

Sample ORC segment 

ORC|RE|2017041006|273013^IRIS||F||||20170410145907|||OP0001^DOE^JACK^^^MD^MD ^^^^^^NPI
Field Name and type Sample value Description
ORC-1 Order Control (ID) RE Always “RE” (Observations/Performed Service to follow)
ORC-2 Placer Order Number (EI) 2017041006  
  ORC-2.1 Entity Identifier 2017041006 Order number provided in ORM HL7 message
  ORC-2.2 Namespace ID   Empty by default
ORC-3 Filler Order Number (EI) 273013^IRIS  
  ORC-3.1 Entity Identifier 273013 Iris’ internal order number; this number is a unique value
  ORC-3.2 Namespace ID IRIS “IRIS” is used as the default value
ORC-4 Placer Group Number (EI)   Empty by default
ORC-5 Order Status (ID) F “F” (for Final) is used by default;Iris does not send preliminary or corrected reports.
ORC-6 Response Flag (ID)   Empty by default
ORC-7 Quantity/Timing (TQ)   Empty by default
ORC-8 Parent Order (EIP)   Empty by default
ORC-9 Date/Time of Transaction (TS) yyyyMMddHHmmss format Current time based on server time (UTC if hosted by Iris)
ORC-10 Entered By (XCN)   Empty by default
ORC-11 Verified By (XCN)   Empty by default
ORC-12 Ordering Provider (XCN) OP0001^DOE^JACK^^ ^MD^MD^^^^^^NPI This reflects the ordering provider received in the ORM HL7 message
  ORC-12.1 ID OP0001 Reflects the ORM HL7 message ORC-12.1 value
  ORC-12.2 Family Name DOE Reflects the ORM HL7 message ORC-12.2 value
  ORC-12.3 Given Name JACK Reflects the ORM HL7 message ORC-12.3 value
…..   OR default C-12.4 & ORC-12.5 empty by default
ORC-12.5 P Prefix MD   Credentials of the ordering physician if available
ORC-12.6 D Degree MD   Credentials of the ordering physician if available
…..   OR C-12.7 through ORC-12.12 Empty by default
ORC-12.13 Code Identifier Type NPI   Provider type identifying code; typically “NPI”

OBR – Observation Request

The observation request segment transmits information about an exam, diagnostic study, or assessment that is specific to an order or result.

Sample OBR segment 

OBR|1|2017041006|273013^IRIS|92250^FUNDUS PHOTOGRAPHY^EAP^^FUNDAL PHOTO|||20170410145803|||||||20170410145803||OP0001^DOE^JACK^^^MD^MD^^^^^^NPI||||||20170410145901|||F|||||||GR0001^DOE^JANE^20170410145901^JANE DOE, MD,NPI: 1234567890, Taxonomy: 207W00000X
Field Name and type Sample value Description  
OBR-1 Set ID - OBR (SI) 1 Always “1”; Iris never sends multiple OBR segments  
OBR-2 Placer Order Number (EI) 2017041006    
  OBR-2.1 Entity Identifier 2017041006 Order number provided in ORMHL7 message  
  OBR-2.2 Namespace ID   Empty by default  
OBR-3 Filler Order Number (EI) 273013^IRIS    
  OBR-3.1 Entity Identifier 273013 Iris’ internal order number. This is a unique value.  
  OBR-3.2 Namespace ID IRIS “IRIS” is used as the default value  
OBR-4 Universal Service Identifier (CE) 92250^FUNDUS PHOTOGRAPHY ^EAP^^FUNDAL PHOTO CPT code in OBR.4.1 followed by the description in OBR.4.2. This value is populated with the values present in the creating ORM message unless otherwise requested. See below for Sample examples  
    EAP777357^Ophthalmology Retinal Scan Sample 1  
    57554^DIABETIC EYE EXAM IN OFFICE ^IRISEAP^^DIABETIC EYE EXAM IN OFFICE Sample 2  
    IMG0555^DIABETIC RETINAL SCREENING (IRIS CAMERA) ^MRGECP^^DIABETIC RETINAL SCREENING Sample 3  
    OPH112^IRIS RETINAL ASSESSMENT^LAB^^OPH94 Sample 4  
OBR-5 Priority (ID)   Empty by default  
OBR-6 Requested Date/Time (TS)   Empty by default  
OBR-7 Observation Date/Time # (TS) yyyyMMddHHmmss format Date of image capture  
OBR-8 Observation End Date/Time # (TS)   Empty by default  
OBR-9 Collection Volume (CQ)   Empty by default  
OBR-10 Collector Identifier (XCN)   Empty by default  
OBR-11 Specimen Action Code (ID)   Empty by default  
OBR-12 Danger Code (CE)   Empty by default  
OBR-13 Relevant Clinical Info. (ST)   Empty by default  
OBR-14 Specimen Received Date/Time (TS) yyyyMMddHHmmss format Date of image capture  
OBR-15 Specimen Source (SPS)   Empty by default  
OBR-16 Ordering Provider (XCN) OP0001^DOE^JACK^^ ^MD^MD^^^^^^NPI Same value as ORC-12  
OBR-17 Order Callback Phone Number (XTN)   Empty by default  
OBR-18 Placer Field 1 (ST)   Empty by default  
OBR-19 Placer Field 2 (ST)   Empty by default  
OBR-20 Filler Field 1 (ST)   Empty by default  
OBR-21 Filler Field 2 (ST)   Empty by default  
OBR-22 Results Report/Status Change - Date/Time (TS) yyyyMMddHHmmss format Date of grading (signing)  
OBR-23 Charge to Practice (MOC)   Empty by default  
OBR-24 Diagnostic Serv Sect ID (ID)   Empty by default  
OBR-25 Result Status (ID) F F = Final, C = Corrected*  
OBR-26 Parent Result (PRL)   Empty by default  
OBR-27 Quantity/Timing (TQ)   Empty by default  
OBR-28 Result Copies To (XCN)   Empty by default  
OBR-29 Parent Number (EIP)   Empty by default  
OBR-30 Transportation Mode (ID)   Empty by default  
OBR-31 Reason for Study (CE)   Empty by default  
OBR-32 Principal Result Interpreter (NDL) GR0001^DOE^JANE ^20170410145901^JANE DOE, MD, NPI: 1234567890, Taxonomy: 207W00000X The default configuration is to send grader details here.  
  OBR-32.1 GR0001 Grader ID in IRIS  
  OBR-32.2 DOE Grader Family Name  
  OBR-32.3 JANE Grader Given Name  
  OBR-32.4 yyyyMMddHHmmss format Date of grading (signing)  
  OBR-32.5 JANE1234207W DOE, MD, NPI: 567890, Taxonomy: 00000X Grader full name with credentials

Iris does not send preliminary or corrected reports but upon request can send a status of “C” when a report has been sent back to be regraded. These are not corrected reports but instead a new report for the existing order.

DG1 Segment – Diagnosis

Optional This is the diagnosis segment that can be used to send multiple diagnoses. This can be generated upon request but is otherwise not part of the Iris standard ORU HL7 message.

See ICD-10 Results for details on how IRIS works with ICD-10 codes.

Sample DG1 segment 

DG1|1||E1141^Type 2 diabetes mellitus with diabetic mononeuropathy^ICD10 
DG1|2||E113291^Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye^ICD10 without macular edema, right eye^ICD10 
DG1|3||E113512^Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye^ICD10
Field Name and type Sample value Description
DG1-1 Set ID - DG1 (SI) 1 The Set ID that corresponds with the number of diagnoses
DG1-2 Diagnosis Coding Method (ID)   Empty by default
DG1-3 Diagnosis Code (CE) E1141^Type 2 diabetes mellitus with diabetic mononeuropathy^ICD10 This reflects the diagnoses added after the image has been graded
  DG1-3.1 Identifier E1141 ICD10 code for diagnosis
  DG1-3.2 Text Type 2 diabetes mellitus with diabetic mononeuropathy Description of diagnosis code
  DG1-3.3 Name of Coding System ICD10 The coding system: Iris currently utilizes ICD10

OBX – Observation Result Segment

The observation result segment is used to transmit a single observation or observation fragment. OBX segments can repeat and each one contains following information.

IRIS’ default OBX HL7 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 (1) 

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 (2) 

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 (3) 

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 (4) 

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 (5) 

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 (6) 

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 (7) 

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 (8) 

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 (9) 

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 segments (10-30) 

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 (31) 

OBX|31|RP|LINK^^PDFLINK|31|https://api.retinalscreenings.com/api/PatientOrders/GetSingle ResultForDisplayInEmr?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  

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:

  • “…?patientOrderId=273013\T\asPdf…” to “…?patientOrderId=273013&asPdf…”

Patient MRN is displayed here:

  • patientOrderId=12345

Document type:

  • aspdf=True

Document status (will always be set to False)

  • isPreliminary=False

Document pointer

  • 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 PDF 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*

Note 2.0: This will contain a Base64 encoded pdf document. An example can be provided upon request.

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