Inbound Observation
Reporting Interface
Specifications
HL7 ORU Message Version 2.5.1
athenahealth, Inc.
Version 1.0 Published: December 2014
Inbound Observation Reporting Interface Specifications
Table of Contents
TABLE OF CONTENTS .............................................................................................................................................................. 2
1.0 – INTRODUCTION ............................................................................................................................................................. 3
1.1 – OVERVIEW ............................................................................................................................................................................ 3
1.2 – CONNECTIVITY ...................................................................................................................................................................... 3
1.3 – ATHENANET MESSAGE EXCHANGE (MX) ENGINE .................................................................................................................... 3
1.4 – HL7 MESSAGE VERSIONING ................................................................................................................................................... 3
2.0 – HL7 ORU MESSAGE SPECIFICATIONS .......................................................................................................................... 4
2.1 – TRIGGER EVENTS .................................................................................................................................................................... 4
2.2 – MESSAGE DEFINITION ............................................................................................................................................................. 4
2.3 – MESSAGE FORMAT................................................................................................................................................................. 4
3.0 – SEGMENT MAPPINGS .................................................................................................................................................... 5
3.1 – MSH MESSAGE HEADER SEGMENT ......................................................................................................................................... 5
3.2 – PID PATIENT IDENTIFICATION SEGMENT .................................................................................................................................... 6
3.3 – PD1 ADDITIONAL DEMOGRAPHICS SEGMENT ......................................................................................................................... 8
3.4 – PV1 PATIENT VISIT SEGMENT................................................................................................................................................... 9
3.5 – ORC ORDER COMMON SEGMENT ...................................................................................................................................... 11
3.6 – OBR OBSERVATION REQUEST SEGMENT ................................................................................................................................ 12
3.7 – OBX OBSERVATION/RESULT SEGMENT .................................................................................................................................. 14
3.8 – SPM SPECIMEN SEGMENT .................................................................................................................................................... 15
3.9 – NTE NOTES AND COMMENTS SEGMENT ................................................................................................................................ 16
4.0 – EXAMPLES OF USE ....................................................................................................................................................... 17
4.1 – AMYLASE, SERUM ................................................................................................................................................................ 17
4.2 – RAPID STREP GROUP A, THROAT........................................................................................................................................... 18
4.3 – CULTURE WITH SENSITIVITY PANEL .......................................................................................................................................... 19
4.4 – CULTURE WITH SENSITIVITY PANEL IN ONE OBR ...................................................................................................................... 20
5.0 – CHANGE LOG ............................................................................................................................................................. 21
5.1 – NEW SEGMENT SUPPORT ...................................................................................................................................................... 21
5.2 – SPM SEGMENT CHANGES .................................................................................................................................................... 21
5.3 – OBX SEGMENT CHANGES .................................................................................................................................................... 21
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Inbound Observation Reporting Interface Specifications
1.0 – Introduction
1.1 – Overview
This document describes the implementation of an application interface using Health Level Seven’s (HL7) ORU message
specifications. athenahealth's observation reporting interface is a unidirectional interface that is utilized for result messages
to be sent outbound from a third party trading partner and inbound to athenaNet. The use-case for the observation
reporting interface encompasses all types of laboratory results, imaging results, and clinically related documentation.
During the interface implementation project, this document should be used as a compliment to the implementation guides
that can be found on athenahealth’s interfaces web page.
1.2 – Connectivity
athenahealth offers a variety of connectivity options to the athenaNet MX Engine, which is athenahealth’s system tool for
exchanging data over an interface. Data exchange partners should work directly with their athenahealth interface project
manager to determine and execute a connectivity plan.
1.3 – athenaNet Message Exchange (MX) Engine
The athenaNet MX Engine is athenahealth’s mechanism for the exchange of HL7 messages. All necessary functionality to
receive, process, and acknowledge an inbound ORU message is implemented using the athenaNet MX Engine.
1.4 – HL7 Message Versioning
This guide discusses the processing of an inbound ORU message as it relates to HL7’s 2.5.1 message specifications. The
athenaNet MX Engine is backwards compatible with HL7 versions 2.2, 2.3, 2.3.1, 2.4, and 2.5.
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Inbound Observation Reporting Interface Specifications
2.0 – HL7 ORU Message Specifications
2.1 – Trigger Events
The athenaNet MX Engine processes inbound ORU messages for laboratory, imaging, and clinical document result-types in
athenaNet. Trigger events that are supported include both R01 (for unsolicited observation messages) and R03 (displayoriented results, query/unsolicited update for backward compatibility only) events.
2.2 – Message Definition
The segment ordering for a 2.5.1 ORU^R01 (unsolicited observation) message is noted below. Segments relevant for default
processing done by the athenaNet MX Engine are denoted using bold text. For the athenaNet MX Engine, segments that
are optional are enclosed with brackets ( [ ] ) while segments enclosed in braces ( { } ) indicate the segment is repeatable.
Segment
Segment Definition
MSH
[ SFT ]
Message Header
Software
Patient Identification
Additional Demographics
Notes and Comments
Next of Kin/Associated Parties
Patient Visit
Patient Visit – Additional Info
Order Common
Observation Request
Notes and Comments
Timing/Quantity
Timing/Quantity Order Sequence
Contact Data
Observation/Result
Notes and Comments
Financial Transaction
Clinical Trial Identification
Specimen
Observation Related to Specimen
Continuation Pointer
PID
[ PD1 ]
[ { NTE } ]
[ { NK1 } ]
[ PV1 ]
[ PV2 ]
[ { ORC } ]
{ OBR }
[ { NTE } ]
[ TQ1 ]
[ { TQ2 } ]
[ CTD ]
[ { OBX } ]
[ { NTE } ]
[ { FT1 } ]
[ { CTI } ]
[ { SPM } ]
[ { OBX } ]
[ DSC ]
2.3 – Message Format
The athenaNet MX engine will process information in the segments described in section 3.0 – Segment Mappings. Segments
are omitted from this guide if the athenaNet MX engine does not by default process information within that segment. If
additional segments or fields are in need of being processed, please discuss this with your athenahealth Interface Project
Manager.
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Inbound Observation Reporting Interface Specifications
3.0 – Segment Mappings
3.1 – MSH Message Header Segment
The MSH segment is used to identify information related to the message including the source, destination, and other specific
items regarding the interface message.
Field
Element
MSH-1
Field Separator
MSH-2
Encoding Characters
MSH-3
Sending Application
MSH-4
Sending Facility
MSH-5
Receiving Application
MSH-6
Receiving Facility
MSH-7
Date/Time of Message
MSH-8
Security
MSH-9
Message Type
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Comments
Required. This field
contains the separator
between the segment ID
(MSH) and the first real
field, MSH-2-encoding
characters.
Required. This field
contains the four
characters in the following
order: the component
separator, repetition
separator, escape
character, and
subcomponent separator.
Required. This field
identifies the type of
result. All types of
laboratory results
(microbiology, pathology,
ect.) may be indicated as
laboratory results.
Required. This field
indicates the primary
sending facility. If results
are obtained from
outreach facilities, this
should be indicated in an
NTE segments associated
with the observation or
observation fragment.
Not Required.
Required. This field
identifies the receiving
facility.
Required. Date and time
associated with the
message.
Not Required.
Required. This field
identifies the type of result
and event trigger.
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Syntax
The expected value is |,
(ASCII 124).
The expected values are ^~\&
(ASCII 94, 126, 92, and 38,
respectively).
LAB, RAD, or TRN are typically
used to identify the result type.
An identifier for the primary
sending facility.
A unique identifier associated
to the physician’s practice is
sent here.
ORU^R01 or ORU^R03
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Inbound Observation Reporting Interface Specifications
MSH-10
Message Control ID
MSH-11
Processing ID
MSH-12
Version ID
MSH-13
Sequence Number
Required. This field should
be used as a unique
identifier for the message.
The athenaNet MX Engine
will not process duplicate
messages.
Not Required.
Required. The athenaNet
MX Engine is backwards
compatible with 2.2, 2.3,
2.3.1, 2.4, and 2.5
Not Required.
MSH-14
Continuation Pointer
Not Required.
MSH-15
Accept Acknowledgment Type
Not Required.
MSH-16
Application Acknowledgement Type
Not Required.
MSH-17
Country Code
Not Required.
MSH-18
Character Set
Not Required.
MSH-19
Principal Language of Message
Not Required.
MSH-20
Alternate Character Set Handling Scheme
Not Required.
MSH-21
Message Profile Identifier
Not Required.
2.5.1 or HL7 message version.
3.2 – PID Patient Identification Segment
For an ORU message type, the athenaNet MX Engine uses the PID segment to associate the result with a patient in
athenaNet. First name, last name, and date of birth are the criteria used by the athenaNet MX Engine for patient matching
logic.
Field
Element
Comments
PID-1
Set ID - PID
Not Required.
PID-2
Patient ID
Not Required.
PID-3
Patient Identifier List
Not Required.
PID-4
Alternate Patient ID - PID
PID-5
Patient Name
PID-6
Mother’s Maiden Name
PID-7
Date/Time of Birth
PID-8
Administrative Sex
PID-9
Patient Alias
Not Required.
The patient name is
necessary for patient
matching logic.
Not Required.
The patient date of birth is
necessary for patient
matching logic.
Not Required. Utilized to
display in the ‘Lab
Demographics’ information
for the ‘Patient’ section of
the result document header.
Not Required.
PID-10
Race
Not Required.
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Syntax Notes
lastname^firstname^mid
dleinitial
YYYYMMDD
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Inbound Observation Reporting Interface Specifications
PID-11
Patient Address
PID-12
County Code
PID-13
Phone Number - Home
PID-14
Phone Number - Business
Not Required. Utilized to
display in the ‘Lab
Demographics’ information
for the ‘Patient’ section of
the result document header.
Not Required.
Not Required. Utilized to
display in the ‘Lab
Demographics’ information
for the ‘Patient’ section of
the result document header.
Not Required.
PID-15
Primary Language
Not Required.
PID-16
Marital Status
Not Required.
PID-17
Religion
Not Required.
PID-18
Patient Account Number
Not Required.
PID-19
SSN Number - Patient
Not Required.
PID-20
Driver's License Number - Patient
Not Required.
PID-21
Mother's Identifier
Not Required.
PID-22
Ethnic Group
Not Required.
PID-23
Birth Place
Not Required.
PID-24
Multiple Birth Indicator
Not Required.
PID-25
Birth Order
Not Required.
PID-26
Citizenship
Not Required.
PID-27
Veterans Military Status
Not Required.
PID-28
Nationality
Not Required.
PID-29
Patient Death Date and Time
Not Required.
PID-30
Patient Death Indicator
Not Required.
PID-31
Identity Unknown Indicator
Not Required.
PID-32
Identity Reliability Code
Not Required.
PID-33
Last Update Date/Time
Not Required.
PID-34
Last Update Facility
Not Required.
PID-35
Species Code
Not Required.
PID-36
Breed Code
Not Required.
PID-37
Strain
Not Required.
PID-38
Production Class Code
Not Required.
PID-39
Tribal Citizenship
Not Required.
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Inbound Observation Reporting Interface Specifications
3.3 – PD1 Additional Demographics Segment
For an ORU message type, the athenaNet MX Engine will use the PD1 segment only when looking for an athenaNet provider
to associate with the result message.
Field
Element
Comments
PD1-1
Living Dependency
Not Required.
PD1-2
Living Arrangement
Not Required.
PD1-3
Patient Primary Facility
PD1-4
Patient Primary Care Provider
Name & ID No.
PD1-5
Student Indicator
Not Required.
This field is not required
when another providerrelated field is used. This
field is used for
athenaNet provider
routing logic.
Not Required.
PD1-6
Handicap
Not Required.
PD1-7
Living Will Code
Not Required.
PD1-8
Organ Donor Code
Not Required.
PD1-9
Separate Bill
Not Required.
PD1-10
Duplicate Patient
Not Required.
PD1-11
Publicity Code
Not Required.
PD1-12
Protection Indicator
Not Required.
PD1-13
Protection Indicator Effective Date
Not Required.
PD1-14
Place of Worship
Not Required.
PD1-15
Advance Directive Code
Not Required.
PD1-16
Not Required.
PD1-18
Immunization Registry Status
Immunization Registry Status
Effective Date
Publicity Code Effective Date
PD1-19
Military Branch
Not Required.
PD1-20
Military Rank/Grade
Not Required.
PD1-21
Military Status
Not Required.
PD1-17
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Syntax Notes
providerid^lastname^firstname
An NPI is preferred as a
provider ID.
Not Required.
Not Required.
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Inbound Observation Reporting Interface Specifications
3.4 – PV1 Patient Visit Segment
For an ORU message type, the athenaNet MX Engine will use the PV1 segment only when looking for an athenaNet provider
to associate with the result message.
Field
Element
Comments
PV1-1
Set ID - PV1
Not Required.
PV1-2
Patient Class
Not Required.
PV1-3
Assigned Patient Location
Not Required.
PV1-4
Admission Type
Not Required.
PV1-5
Preadmit Number
Not Required.
PV1-6
Prior Patient Location
PV1-9
Consulting Doctor
PV1-10
Hospital Service
Not Required.
This field is not required
when another
provider-related field is
used. This field is used
for athenaNet provider
routing logic.
This field is not required
when another
provider-related field is
used. This field is used
for athenaNet provider
routing logic.
This field is not required
when another
provider-related field is
used. This field is used
for athenaNet provider
routing logic.
Not Required.
PV1-11
Temporary Location
Not Required.
PV1-12
Preadmit Test Indicator
Not Required.
PV1-13
Re-admission Indicator
Not Required.
PV1-14
Admit Source
Not Required.
PV1-15
Ambulatory Status
Not Required.
PV1-16
VIP Indicator
PV1-7
PV1-8
Attending Doctor
Referring Doctor
PV1-17
Admitting Doctor
PV1-18
Patient Type
Not Required.
This field is not required
when another
provider-related field is
used. This field is used
for athenaNet provider
routing logic.
Not Required.
PV1-19
Visit Number
Not Required.
PV1-20
Financial Class
Not Required.
PV1-21
Charge Price Indicator
Not Required.
PV1-22
Courtesy Code
Not Required.
PV1-23
Credit Rating
Not Required.
PV1-24
Contract Code
Not Required.
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Syntax Notes
providerid^lastname^firstname
An NPI is preferred as a
provider ID.
providerid^lastname^firstname
An NPI is preferred as a
provider ID.
providerid^lastname^firstname
An NPI is preferred as a
provider ID.
providerid^lastname^firstname
An NPI is preferred as a
provider ID.
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Inbound Observation Reporting Interface Specifications
PV1-25
Contract Effective Date
Not Required.
PV1-26
Contract Amount
Not Required.
PV1-27
Contract Period
Not Required.
PV1-28
Interest Code
Not Required.
PV1-29
Transfer to Bad Debt Code
Not Required.
PV1-30
Transfer to Bad Debt Date
Not Required.
PV1-31
Bad Debt Agency Code
Not Required.
PV1-32
Bad Debt Transfer Amount
Not Required.
PV1-33
Bad Debt Recovery Amount
Not Required.
PV1-34
Delete Account Indicator
Not Required.
PV1-35
Delete Account Date
Not Required.
PV1-36
Discharge Disposition
Not Required.
PV1-37
Discharged to Location
Not Required.
PV1-38
Diet Type
Not Required.
PV1-39
Servicing Facility
Not Required.
PV1-40
Bed Status
Not Required.
PV1-41
Account Status
Not Required.
PV1-42
Pending Location
Not Required.
PV1-43
Prior Temporary Location
Not Required.
PV1-44
Admit Date/Time
Not Required.
PV1-45
Discharge Date/Time
Not Required.
PV1-46
Current Patient Balance
Not Required.
PV1-47
Total Charges
Not Required.
PV1-48
Total Adjustments
Not Required.
PV1-49
Total Payments
Not Required.
PV1-50
Alternate Visit ID
Not Required.
PV1-51
Visit Indicator
Not Required.
This field is not required
when another
provider-related field is
used. This field is used
for athenaNet provider
routing logic.
PV1-52
Other Healthcare Provider
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providerid^lastname^firstname
An NPI is preferred as a
provider ID.
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Inbound Observation Reporting Interface Specifications
3.5 – ORC Order Common Segment
For an ORU message type, the athenaNet MX Engine will use the ORC segment only when looking for an athenaNet
provider to associate with the result message.
Field
Element
Comments
Syntax Notes
ORC-1
Order Control
Not Required.
Order Control ID
ORC-2
Placer Order Number
Not Required.
ORC-3
Filler Order Number
Not Required.
ORC-4
Placer Group Number
Not Required.
ORC-5
Order Status
Not Required.
ORC-6
Response Flag
Not Required.
ORC-7
Quantity/Timing
Not Required.
ORC-8
Parent
Not Required.
ORC-9
Date/Time of Transaction
Not Required.
ORC-10
Entered By
Not Required.
ORC-11
Verified By
ORC-12
Ordering Provider
ORC-13
Enterer's Location
Not Required.
This field is not
required when
another providerrelated field is
used. This field is
used for athenaNet
provider routing
logic.
Not Required.
ORC-14
Call Back Phone Number
Not Required.
ORC-15
Order Effective Date/Time
Not Required.
ORC-16
Order Control Code Reason
Not Required.
ORC-17
Entering Organization
Not Required.
ORC-18
Entering Device
Not Required.
ORC-19
Action By
Not Required.
ORC-20
Advanced Beneficiary Notice Code
Not Required.
ORC-21
Ordering Facility Name
Not Required.
ORC-22
Ordering Facility Address
Not Required.
ORC-23
Ordering Facility Phone Number
Not Required.
ORC-24
Ordering Provider Address
Not Required.
ORC-25
Not Required.
ORC-27
Order Status Modifier
Advanced Beneficiary Notice Override
Reason
Filler's Expected Availability Date/Time
ORC-28
Confidentiality Code
Not Required.
ORC-29
Order Type
Not Required.
ORC-30
Enterer Authorization Mode
Not Required.
ORC-31
Parent Universal Service Identifier
Not Required.
ORC-26
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providerid^lastname^firstname
An NPI is preferred as a
provider ID.
Not Required.
Not Required.
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Inbound Observation Reporting Interface Specifications
3.6 – OBR Observation Request Segment
The OBR segment contains information relevant to the originating order for the result message. It is a header of the result
document.
Field
Element
OBR-1
Set ID - OBR
OBR-2
Placer Order Number
OBR-3
Filler Order Number
OBR-4
Universal Service Identifier
OBR-5
Priority - OBR
OBR-6
Requested Date/Time
OBR-7
Observation Date/Time
OBR-8
Observation End Date/Time
This field represents the
sequence number.
Not Required. This field is
the ordering facility’s
order number.
Not Required. This field is
the order filler’s order
number. Also known as
the external accession
identifier, this field is
interpreted as the
‘Specimen/Accession ID’
on a result document.
This field represents the
code and description. For
laboratory and imaging
results, descriptions are
displayed in the chart.
A “1” indicates the result
is urgent.”2” or no value
indicates the result is not
urgent.
Not Required.
This field is interpreted as
the ‘Specimen Coll. Date’
on a result document.
Not Required.
OBR-9
Collection Volume
Not Required.
OBR-10
Collector Identifier
Not Required.
OBR-11
Specimen Action Code
Not Required.
OBR-12
Danger Code
Not Required.
OBR-13
Relevant Clinical Information
OBR-14
Specimen Received Date/Time
OBR-15
Specimen Source
Not Required.
Used for backwards
compatibility. This field is
interpreted as the
‘Specimen Rec. Date’ on
a result document.
Used for backwards
compatibility. This field is
interpreted as the
‘Specimen Source’ on a
result document.
This field is not required
when another providerrelated field is used. This
field is used for athenaNet
provider routing logic.
Not Required.
OBR-16
OBR-17
Comments
Ordering Provider
Order Callback Phone Number
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Syntax Notes
code^description
1 or 2, 1 will indicate the
result is “Urgent”.
providerid^lastname^firstn
ame
An NPI is preferred as a
provider ID.
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Inbound Observation Reporting Interface Specifications
OBR-18
Placer Field 1
OBR-19
Placer Field 2
Not Required. This field is
the default for documentlevel PACS link
functionality within
athenaNet.
Not Required.
OBR-20
Filler Field 1
Not Required.
OBR-21
Filler Field 2
OBR-22
Results Rpt/Status Chng Date/Time
OBR-23
Charge to Practice
Not Required.
This field is interpreted as
the ‘Specimen Reported
Date’ on a result
document.
Not Required.
OBR-24
Diagnostic Serv Sect ID
OBR-25
Result Status
OBR-26
Parent Result
OBR-27
Quantity/Timing
Not Required.
This field is used to
indicate the result’s
overall status. For a list of
the default statuses,
please see the
Observation and Result
Flags section.
Not Required.
OBR-29
Parent
Not Required.
This field is not required
when another providerrelated field is used. This
field is used for athenaNet
provider routing logic.
Not Required.
OBR-30
Transportation Mode
Not Required.
OBR-31
Reason for Study
Not Required.
OBR-32
Principal Result Interpreter
Not Required.
OBR-33
Assistant Result Interpreter
Not Required.
OBR-34
Technician
Not Required.
OBR-35
Transcriptionist
Not Required.
OBR-36
Scheduled Date/Time
Not Required.
OBR-37
Number of Sample Containers
Transport Logistics of Collected
Sample
Collector's Comment
Transport Arrangement
Responsibility
Transport Arranged
Not Required.
Escort Required
Planned Patient Transport
Comment
Procedure Code
Not Required.
Procedure Code Modifier
Placer Supplemental Service
Information
Filler Supplemental Service
Information
Not Required.
OBR-28
OBR-38
OBR-39
OBR-40
OBR-41
OBR-42
OBR-43
OBR-44
OBR-45
OBR-46
OBR-47
Result Copies To
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providerid^lastname^firstn
ame
An NPI is preferred as a
provider ID.
Not Required.
Not Required.
Not Required.
Not Required.
Not Required.
Not Required.
Not Required.
Not Required.
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Inbound Observation Reporting Interface Specifications
OBR-49
Medically Necessary Duplicate
Procedure Reason
Result Handling
OBR-50
Parent Universal Service Identifier
OBR-48
Not Required.
Not Required.
Not Required.
3.7 – OBX Observation/Result Segment
The OBX segment is used to transmit a single observation or observation fragment that is associated with the result
document.
Field
Element
OBX-1
Set ID – OBX
OBX-2
Value Type
OBX-3
Observation Identifier
OBX-4
Observation Sub-ID
OBX-5
Observation Value
OBX-6
Units
OBX-7
References Range
OBX-8
Abnormal Flags
OBX-9
Probability
OBX-10
Nature of Abnormal Test
OBX-11
Observation Result Status
OBX-12
OBX-13
OBX-14
Effective Date of Reference
Range Values
User Defined Access Checks
Date/Time of the
Observation
Comments
This field represents the sequence
number.
This field contains the observation value
(OBX-5) format.
Required to indicate the name of the
analyte. The analyte name is
determined by the second component.
Not Required.
This field is used to indicate the ‘Result’
field for an observation.
This field is used to indicate the ‘Units’ of
an observation.
This field is used as the ‘Ref. Range’ for
an observation.
This value in this field will indicate the
normalcy status of an observation. For a
list of the default statuses, please see the
Observation and Result Flags section.
Not Required.
Not Required.
Not Required.
Not Required.
OBX-15
Producer's Reference
OBX-16
Responsible Observer
OBX-17
Observation Method
Not Required.
OBX-18
Equipment Instance Identifier
Not Required.
OBX-19
Date/Time of the Analysis
Reserved for harmonization
with V2.6
Reserved for harmonization
Not Required.
OBX-21
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code^description
Not Required.
This field will display the observation or
observation fragment’s result status. For
a list of the default statuses, please see
the Observation and Result Flags section.
This field can be used to indicate the
responsible producing service of the
observation fragment. It displays as the
‘Lab’ next to an individual analyte.
Not Required.
OBX-20
Syntax Notes
Not Required.
Not Required.
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Inbound Observation Reporting Interface Specifications
with V2.6
OBX-22
Reserved for harmonization
with V2.6
OBX-23
Performing Organization
Name
OBX-24
Performing Organization
Address
OBX-25
Performing Organization
Medical Director
Not Required.
This field is used to display the
performing facility information on a result
document.
This field is used to display the
performing facility information on a result
document.
This field is used to display the
performing facility information on a result
document.
3.8 – SPM Specimen Segment
The athenaNet MX Engine uses the SPM segment to process and display information related to the specimen.
Field
Element
SPM-1
Set ID – SPM
SPM-2
Specimen ID
This field represents
the sequence
number.
Not Required.
SPM-3
Specimen Parent IDs
Not Required.
SPM-4
Specimen Type
Not Required.
SPM-5
Specimen Type Modifier
Not Required.
SPM-6
Specimen Additives
Not Required.
SPM-7
Specimen Collection Method
SPM-8
Specimen Source Site
SPM-9
Specimen Source Site Modifier
Not Required.
This field is
interpreted as the
‘Specimen Source’
on a result
document.
Not Required.
SPM-10
Specimen Collection Site
Not Required.
SPM-11
Specimen Role
Not Required.
SPM-12
Specimen Collection Amount
Not Required.
SPM-13
Grouped Specimen Count
Not Required.
SPM-14
Specimen Description
Not Required.
SPM-15
Specimen Handling Code
Not Required.
SPM-16
Specimen Risk Code
Not Required.
SPM-17
Specimen Collection Date/Time
SPM-18
Specimen Received Date/Time
SPM-19
Specimen Expiration Date/Time
Not Required.
This field is
interpreted as the
‘Specimen Rec.
Date’ on a result
document.
Not Required.
SPM-20
Specimen Availability
Not Required.
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Syntax Notes
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Inbound Observation Reporting Interface Specifications
SPM-21
Specimen Reject Reason
Not Required.
SPM-22
Specimen Quality
Not Required.
SPM-23
Specimen Appropriateness
Not Required.
SPM-24
Specimen Condition
Not Required.
SPM-25
Specimen Current Quantity
Not Required.
SPM-26
Number of Specimen Containers
Not Required.
SPM-27
Container Type
Not Required.
SPM-28
Container Condition
Not Required.
SPM-29
Specimen Child Role
Not Required.
3.9 – NTE Notes and Comments Segment
The NTE segment is used to display notes specific to the specimens, observation fragments, or the originating order. These
notes will display on result documents as result notes or notes from the laboratory.
Field
Element
NTE-1
Set ID - NTE
NTE-2
Source of Comment
This field represents the sequence
number.
Not Required.
NTE-3
Comment
Textual comment to display.
NTE-4
Comment Type
Not Required.
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Syntax Notes
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Inbound Observation Reporting Interface Specifications
4.0 – Examples of Use
4.1 – Amylase, Serum
MSH|^~\&|LAB|NASON|Athena|2964|201410231332540600||ORU^R01^ORU_R01|20087.3|D|2.5.1|||AL|NE|||||LRI_NG_RU_Profile^HL7^2.16.840.1.113883.9.19^ISO
PID|1||V001047^^^&&ISO^MR^&&ISO~T00001059^^^&&ISO^XX^&&ISO~V00018739^^^&&ISO^AN^&&ISO||test^michael^^^^^L||1987
0711|M||2131-1^Other Race^HL70005|^^^^^USA^H|||||||||||||||||||N|||201410061026-0600|VVH^^ISO
NTE|1|P|testing|RE^Remark^HL70364^C^Comment^L^2.5.1^V1
ORC|RE|1618-1^LAB.VVH^^ISO|1023:RC00001R-1^LAB.VVH^^ISO|1023:RC00001R^2060^^ISO||N|||201410231332540600|||SMIJ^SMITH^JOHN^^^^MD^^MIS&&ISO^L^^^XX^&&ISO^^^^^^^MD||^WPN^PH^^1^970^3286357^^Hospital
Line|201410231322-0600||Main Lab|13045VVH|||Main Lab^L|Valley View Hospital^1906 Blake Ave.^Glenwood
Spgs^CO^81601^USA^B|^WPN^PH^^1^970^3847590|Eagle Valley Medical Clinic^377 Sylvan Lake Road^Eagle^CO^81631^USA^B
OBR|1|1618-1^LAB.VVH^^ISO|1023:RC00001R-1^LAB.VVH^^ISO|AMY^AMYLASE^L^^^^2.40^1.2^AMYLASE| ||2014102313220600|201410231322-0600||scj|O|||2014102315100600||SMIJ^SMITH^JOHN^^^^MD^^MIS&&ISO^L^^^XX^&&ISO^^^^^^^MD|^WPN^PH^^1^970^3286357^^Hospital
Line|00001532|||Main Lab|20141023133200-0600||LAB|C
TQ1|1||||||201410231322-0600|201410231322-0600|R
OBX|1|NM|AMY^AMYLASE^L^^^^2.40^1^AMYLASE||1002|U/L^enzyme unit per liter^UCUM^U/L^U/L^L|25115|H|||C|||201410231322-0600|ML^Main Lab^L|A^^AMYLASE^AMYLASE^55435.000|||201410231332-0600||||Main
Lab^D^^^^CLIA&2.16.840.1.113883.4.7&ISO|Valley View Hospital^1906 Blake Ave.^Glenwood
Spgs^CO^81601^USA^B|^Refior^Jeanette^^^^^^NPI&2.16.840.1.113883.4.6&ISO^L^^^NPI^VVH&&ISO
NTE|1|L|--- 10/23/14 1332 ---|RE^Remark^HL70364^^^^2.5.1
NTE|2|L|AMYLASE previously reported as:|RE^Remark^HL70364^^^^2.5.1
NTE|3|L| 102 U/L|RE^Remark^HL70364^^^^2.5.1
NTE|4|L||RE^Remark^HL70364^^^^2.5.1
SPM|1|00001532&&&ISO^2060&&&ISO|1023:RC00001R^2060|Saliva|||||||||||||201410231322-0600^2014102313220600|201410231510-0600||||||||0.1|^GREEN GEL (LI)
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Inbound Observation Reporting Interface Specifications
4.2 – Rapid Strep Group A, Throat
MSH|^~\&|LAB|NASON|Athena|2964|201411071248100600||ORU^R01^ORU_R01|21391.1|D|2.5.1|||AL|NE|||||LRI_NG_RU_Profile^HL7^2.16.840.1.113883.9.19^ISO
PID|1||V001047^^^&&ISO^MR^&&ISO~T00001059^^^&&ISO^XX^&&ISO~V00018739^^^&&ISO^AN^&&ISO||Test^michael^^^^^L||1987
0711|M||2131-1^Other Race^HL70005|^^^^^USA^H|||||||||||||||||||N|||201410280855-0600|VVH^^ISO
NTE|1|P|Message Testing from Lab|RE^Remark^HL70364^C^Comment^L^2.5.1^V1
ORC|RE|1718-1^LAB.VVH^^ISO|14:MR0005021R-1^LAB.VVH^^ISO|14:MR0005021R^2149^^ISO||N|||2014110712480600|||SMIJ^SMITH^JOHN^^^^^^MIS&&ISO^L^^^XX^^^^^^^^MD||^WPN^PH^^1^970^3286357^^Hospital Line|2014110712440600||Main Lab|13045VVH|||Main Lab^L|Valley View Hospital^1906 Blake Ave.^Glenwood
Spgs^CO^81601^^B|^WPN^PH^^1^970^3847590|Eagle Valley Medical Clinic^377 Sylvan Lake Road^Eagle^CO^81631^USA^B
OBR|1|1718-1^LAB.VVH^^ISO|14:MR0005021R-1^LAB.VVH^^ISO|GAS^GRP A STREP SCREEN-RAPID^L^GAS^GRP A STREP SCREENRAPID^L^2.40^^GRP A STREP SCREEN-RAPID|||201411071244-0600|201411071244-0600||scj|O|||2014110713560600||SMIJ^SMITH^JOHN^^^^^^MIS&&ISO^L^^^XX^^^^^^^^MD|^WPN^PH^^1^970^3286357^^Hospital Line|00001616||MR|Main
Lab|20141107124700-0600||MB|X|||||||
NTE|1|QRY|Extra Note from Lab
TQ1|1||||||201411071244-0600|201411071244-0600|R
OBX|1|ST|GAS^RAPID GROUP A STREP:^L||POSITIVE|||A|||X|||201411071244-0600|ML^Main Lab||||201411071245-0600||||Main
Lab^D^^^^CLIA&2.16.840.1.113883.4.7&ISO|Valley View Hospital^1906 Blake Ave.^Glenwood
Spgs^CO^81601^USA^B|^Refior^Jeanette^^^^^^NPI&2.16.840.1.113883.4.6&ISO^L^^^NPI^VVH&&ISO
SPM|1|00001616&&&ISO^2149&&&ISO|14:MR0005021R^2149|UDENT^Source,
Unidentified^HL70487^RTT^THROAT^L^20100831^2.5.1^RTT|||||||||||||201411071244-0600^201411071244-0600|2914110713560600||||||||2|^EIA TEST MIC
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Inbound Observation Reporting Interface Specifications
4.3 – Culture with Sensitivity Panel
athenaNet creates unique result documents for cultures and their sensitivity panels. It is recommended to use a TX-type OBX
segment at the beginning of the sensitivity panel OBR to indicate the organism that is associated to the panel.
MSH|^~\&|LAB|NASON|Athena|2964|201411180911000700||ORU^R01^ORU_R01|21628.4|D|2.5.1|||AL|NE|||||LRI_NG_RU_Profile^HL7^2.16.840.1.113883.9.19^ISO
PID|1||V001047^^^&&ISO^MR^&&ISO~T00001059^^^&&ISO^XX^&&ISO~V00018739^^^&&ISO^AN^&&ISO||Test^michael^^^^^L||1987
0711|M||2131-1^Other Race^HL70005|^^^^^USA^H|||||||||||||||||||N|||201410280855-0700|VVH^^ISO
ORC|RE|1720-1^LAB.VVH^^ISO|14:AR0009135R-1^LAB.VVH^^ISO|14:AR0009135R^2151^^ISO||N|||2014111809110700|||SMIJ^SMITH^JOHN^^^^^^MIS&&ISO^L^^^XX^^^^^^^^MD||^WPN^PH^^1^970^3286357^^Hospital Line|2014110714050700||Main Lab|14134VVH|||Main Lab^L|Valley View Hospital^1906 Blake Ave.^Glenwood
Spgs^CO^81601^^B|^WPN^PH^^1^970^3847590|Eagle Valley Medical Clinic^377 Sylvan Lake Road^Eagle^CO^81631^USA^B
OBR|1|1720-1^LAB.VVH^^ISO|14:AR0009135R-1^LAB.VVH^^ISO|XXUC^URINE CULTURE^L^XXUC^URINE CULTURE^L^2.40^^URINE
CULTURE| ||201411071405-0600|2014110714050600||SELTEST|O|||||SMIJ^SMITH^JOHN^^^^^^MIS&&ISO^L^^^XX^^^^^^^^MD|^WPN^PH^^1^970^3286357^^Hospital
Line|00001618||MBAR|Main Lab|20141118091000-0700||MB|A
TQ1|1||||||201411071405-0700|201411071405-0700|R
OBX|1|CWE|^^^^^^^^URINE CULTURE|1|ESCHERICHIA COLI^O:EC-1^L^EC-1^ESCHERICHIA COLI^L^2014111809^^ESCHERICHIA
COLI|||||||||201411071405-0700|ML^Main Lab||||201411180910-0700||||Main Lab^D^^^^CLIA&2.16.840.1.113883.4.7&ISO|Valley
View Hospital^1906 Blake Ave.^Glenwood
Spgs^CO^81601^USA^B|^Refior^Jeanette^^^^^^NPI&2.16.840.1.113883.4.6&ISO^L^^^NPI^VVH&&ISO
NTE|1|L|COLONY COUNT >100,000 CFU/ML, 1 COLONY TYPE(S),|RE^Remark^HL70364^^^^2.5.1
NTE|2|L| ESCHERICHIA COLI 73114010|RE^Remark^HL70364^^^^2.5.1
SPM|1|00001618&&&ISO^2151&&&ISO|14:AR0009135R^2151| ||||||||||||||201411071405-0700
OBR|2|1720-2^LAB.VVH^^ISO|14:AR0009135R-2^LAB.VVH^^ISO|XXMSN^ID/MIC NEG^L^XXMSN^ID/MIC NEG^L^2.40^^ID/MIC NEG|
||201411071405-0600|2014110714050600||SELTEST|O|||||SMIJ^SMITH^JOHN^^^^^^MIS&&ISO^L^^^XX^^^^^^^^MD|^WPN^PH^^1^970^3286357^^Hospital
Line|00001618||MBAR|Main Lab|20141118091000-0700||MB|A|&&&&&&&&URINE CULTURE^1|||17201&LAB.VVH&&ISO^14:AR0009135R-1&LAB.VVH&&ISO|||27097&UNKNOWN&U&Lauck&Susan&&&&&&ISO
OBX|1|TX|||Organism: ESCHERICHIA||||||F
OBX|2|SN|AM^AMPICILLIN^L^AM^AMPICILLIN^L^2.40^^AMPICILLIN|1|>16|||R||||||201411071405-0700|ML^Main
Lab||||201411180910-0700||||Main Lab^D^^^^CLIA&2.16.840.1.113883.4.7&ISO|Valley View Hospital^1906 Blake Ave.^Glenwood
Spgs^CO^81601^USA^B|^Refior^Jeanette^^^^^^NPI&2.16.840.1.113883.4.6&ISO^L^^^NPI^VVH&&ISO
OBX|3|SN|CFZ^CEFAZOLIN^L^CFZ^CEFAZOLIN^L^2.40^^CEFAZOLIN|1|<8|||S||||||201411071405-0700|ML^Main
Lab||||201411180910-0700||||Main Lab^D^^^^CLIA&2.16.840.1.113883.4.7&ISO|Valley View Hospital^1906 Blake Ave.^Glenwood
Spgs^CO^81601^USA^B|^Refior^Jeanette^^^^^^NPI&2.16.840.1.113883.4.6&ISO^L^^^NPI^VVH&&ISO
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Inbound Observation Reporting Interface Specifications
4.4 – Culture with Sensitivity Panel in One OBR
MSH|^~\&|LAB|NASON|General Surgery Assoc|2964|20141112113914||ORU^R01|20143160003401|P|2.5.1
PID|1|V254054|V254054||TEST^MICHAEL||19870711|M|||17 WASHINGTON ST.^^BRIGHTON^MA^02135||970366-4944|9709457084||S||V34397505|016-37-6999
ORC|RE||F610934|N1002.1035||||||||111222334^NAGENGAST^STEPHEN^M ^^^^^^^^^NPI
OBR|1||F610934|WDC^WOUND CULTURE^^21020-3^BACTERIA IDENTIFIED^LN|||20141106150000|||||||20141107095400|LEFT
KNEE|AMM^NAGENGAST^STEPHEN^M (MD)^^^^^^^^^NPI|||||^|201411121139||MC^MB|P||^^^^^|O1097^JAMESON^DAVID^B
(MD)~^~^||||||2
OBX|1|ST|SDES^SPECIMEN DESCRIPTION|1|ABDOMEN ||||||F||||NL|2234|||201411070959
OBX|2|ST|SREQ^SPECIAL REQUESTS|1|AEROBIC AND ANAEROBIC CULTURE ||||||F||||NL|2234|||201411070959
OBX|3|ST|GS^GRAM STAIN|1|NO ORGANISMS SEEN ||||||F||||WL|596|||201411071423
OBX|4|ST|CULT^CULTURE|1|ESCHERICHIA COLI ||||||F||||WL|515|||201411121138
OBX|4|ST|CULT^CULTURE|2|ENTEROCOCCUS FAECALIS ||||||||||WL|515|||201411121138
OBX|4|ST|CULT^CULTURE|3|COAGULASE NEGATIVE STAPHYLOCOCCUS ||||||||||WL|515|||201411121138
OBX|5|ST|RPT^REPORT STATUS|1|PENDING ||||||I||||||||
OBX|6|ST|ORG^****ORGANISM|1|ESCHERICHIA COLI ||||||F||||WL|277|||201411101014
OBX|7|ST|MTYP^METHOD|1|BLOOD AND TISSUE MIC ||||||F||||WL|277|||201411101014
OBX|8|ST|TSO^TMP/SMX (PO)|1|<=2/38 S |||S|||F||||WL|277|||201411101014
OBX|9|ST|CTAXI^CEFTRIAXONE (IV)|1|<=8 S1 |||S|||F||||WL|277|||201411101014
OBX|10|ST|CPO^CIPROFLOXACIN (PO)|1|<=1 S1 |||S|||F||||WL|277|||201411101014
OBX|11|ST|ORG_1^****ORGANISM|1|ENTEROCOCCUS FAECALIS ||||||F||||WL|515|||201411121138
OBX|12|ST|MTYP_1^METHOD|1|BLOOD AND TISSUE MIC ||||||F||||WL|515|||201411121138
OBX|13|ST|VANI_1^VANCOMYCIN (IV)|1|<=2 S1 |||S|||F||||WL|515|||201411121138
OBX|14|ST|AMPI_1^AMPICILLIN (IV)|1|0.5 S1 |||S|||F||||WL|515|||201411121138
SPM|1|00001532&&&ISO^2060&&&ISO|1023:RC00001R^2060|LEFT KNEE^^^L^2.5.1^2.5.1^BLD|||||||||||||2014102313220600^201410231322-0600|20141107095400||||||||0.1|^GREEN GEL (LI)
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Inbound Observation Reporting Interface Specifications
5.0 – Change Log
5.1 – New Segment Support

athenahealth’s inbound ORU interface processes information in segments denoted in bold text in 2.2 – Message
Definition. Segments that adhere to a 2.5.1 ORU message, R01 trigger event will parse through the athenaNet MX
Engine although information is not read from all segments. New segments that can be sent include SFT, TQ1, TQ2,
CTD, FT1, and SPM. See 2.2 – Message Definition for segment ordering.
5.2 – SPM Segment Changes


Specimen Received Date and Time – Regarding the display of the Specimen Received Date and Time field, OBR-14
is available to be used for backwards compatibility. The athenaNet MX Engine will by default look to SPM-18 for the
Specimen Received Date and Time.
Specimen Source – Regarding the display of the Specimen Source field, OBR-15 is available to be used for
backwards compatibility. The athenaNet MX Engine will by default look to SPM-8 for the Specimen Source.
5.3 – OBX Segment Changes

OBX-23, OBX-24, and OBX-25 are now used to display in the ‘Performing Lab’ section of a result document.
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