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 provides the following options for Observation Results
- Embedded PDF report - Base64 encoded PDF in single segment
- Narrative - Unformatted report content by line
- Discrete Results - See Discrete Results page
- Report Link - URI to PDF report
- Reference Pointer - Path to local file system location for PDF report
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 | 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.