ORU Specification and Sample Messages

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
1.2
1.3
1.4
OVERVIEW............................................................................................................................................. 3
CONNECTIVITY........................................................................................................................................ 3
ATHENANET MESSAGE EXCHANGE (MX) ENGINE........................................................................................... 3
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.................................................................................................................................. 5
3.0 SEGMENT MAPPINGS..................................................................................................... 5
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3.9
MSH MESSAGE HEADER SEGMENT............................................................................................................. 5

PID PATIENT IDENTIFICATION SEGMENT....................................................................................................... 7
PD1 ADDITIONAL DEMOGRAPHICS SEGMENT................................................................................................ 8
PV1 PATIENT VISIT SEGMENT.................................................................................................................... 9
ORC ORDER COMMON SEGMENT............................................................................................................. 11
OBR OBSERVATION REQUEST SEGMENT.................................................................................................... 13
OBX OBSERVATION/RESULT SEGMENT....................................................................................................... 15
SPM SPECIMEN SEGMENT...................................................................................................................... 16
NTE NOTES AND COMMENTS SEGMENT.................................................................................................... 17
4.0 EXAMPLES OF USE....................................................................................................... 18

4.1
4.2
4.3
4.4
AMYLASE, SERUM................................................................................................................................. 18
RAPID STREP GROUP A, THROAT............................................................................................................. 19
CULTURE WITH SENSITIVITY PANEL............................................................................................................ 20
CULTURE WITH SENSITIVITY PANEL IN ONE OBR......................................................................................... 21
5.0 CHANGE LOG............................................................................................................... 22

5.1 NEW SEGMENT SUPPORT........................................................................................................................ 22
5.2 SPM SEGMENT CHANGES....................................................................................................................... 22
5.3 OBX SEGMENT CHANGES....................................................................................................................... 22
1.0 Introduction
www.athenahealth.com
athenahealth, Inc. Confidential and Proprietary
1.1 Overview
This document describes the implementation of an application interface using Health Level Sevens (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 athenahealths interfaces web page.
1.2 Connectivity
athenahealth offers a variety of connectivity options to the athenaNet MX Engine, which is athenahealths 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 athenahealths 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 HL7s 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.
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 (display-oriented 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
Message Header
[ SFT ]
Software
PID
Patient Identification
[ PD1 ]
Additional Demographics
[ { NTE } ]
Notes and Comments
[ { NK1 } ]
Next of Kin/Associated Parties
[ PV1 ]
Patient Visit
[ PV2 ]
Patient Visit Additional Info
[ { ORC } ]
Order Common
{ OBR }
Observation Request
[ { NTE } ]
Notes and Comments
[ TQ1 ]
Timing/Quantity
[ { TQ2 } ]
Timing/Quantity Order Sequence
[ CTD ]
Contact Data
[ { OBX } ]
Observation/Result
[ { NTE } ]
Notes and Comments
[ { FT1 } ]
Financial Transaction
[ { CTI } ]
Clinical Trial Identification
[ { SPM } ]
Specimen
[ { OBX } ]
Observation Related to Specimen
[ DSC ]
Continuation Pointer
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.
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
Comments
Syntax
MSH-1
Field Separator
Required. This field

contains the
separator between
the segment ID (MSH)
and the first real
field, MSH-2-encoding
characters.
The expected value is |,

(ASCII 124).
MSH-2
Encoding Characters

contains the four
characters in the
following order: the
component separator,
repetition separator,
escape character, and
subcomponent
separator.
The expected values are

^~\& (ASCII 94, 126, 92,
and 38, respectively).
MSH-3
Sending Application

identifies the type of
result. All types of
laboratory results
(microbiology,
pathology, ect.) may
be indicated as
laboratory results.
LAB, RAD, or TRN are

typically used to identify
the result type.
MSH-4
Sending Facility

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.
An identifier for the

primary sending facility.
MSH-5
Receiving Application
Not Required.
MSH-6
Receiving Facility

identifies the
receiving facility.
MSH-7
Date/Time of Message
Required. Date and

time associated with
the message.
MSH-8
Security
Not Required.
A unique identifier
associated to the
physicians practice is
sent here.
MSH-9
Message Type

identifies the type of
result and event
trigger.
MSH-10
Message Control ID

should be used as a
unique identifier for
the message. The
athenaNet MX Engine
will not process
duplicate messages.
MSH-11
Processing ID
Not Required.
MSH-12
Version ID
Required. The
athenaNet MX Engine
is backwards
compatible with 2.2,
2.3, 2.3.1, 2.4, and
2.5
MSH-13
Sequence Number
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.
ORU^R01 or ORU^R03
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
Not Required.
PID-5
Patient Name
The patient name is

necessary for patient
matching logic.
PID-6
Mothers Maiden Name
Not Required.
PID-7
Date/Time of Birth
The patient date of

birth is necessary for
patient matching logic.
PID-8
Administrative Sex
Not Required. Utilized

to display in the Lab
Demographics
information for the
Patient section of the
result document header.
PID-9
Patient Alias
Not Required.
PID-10
Race
Not Required.
PID-11
Patient Address

Demographics
information for the
PID-12
County Code
Not Required.
PID-13
Phone Number - Home

Demographics
information for the
PID-14
Phone Number - Business
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.
Syntax Notes
lastname^firstname^
middleinitial
YYYYMMDD
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.
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
Not Required.
PD1-4
Patient Primary Care

Provider Name & ID No.
This field is not

required when
another providerrelated field is used.
This field is used for
athenaNet provider
routing logic.
PD1-5
Student Indicator
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
Immunization Registry
Status
Not Required.
PD1-17
Immunization Registry
Status Effective Date
Not Required.
PD1-18
Publicity Code Effective Date
Not Required.
PD1-19
Military Branch
Not Required.
PD1-20
Military Rank/Grade
Not Required.
PD1-21
Military Status
Not Required.
Syntax Notes
providerid^lastname^first
name
An NPI is preferred as a
provider ID.
10
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
11
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
Not Required.
PV1-7
Attending Doctor
This field is not

required when
another providerrelated field is
used. This field is
used for athenaNet
provider routing
logic.
name
This field is not

required when
used. This field is
used for athenaNet
provider routing
logic.
name
This field is not

required when
used. This field is
used for athenaNet
provider routing
logic.
name
PV1-8
PV1-9
Referring Doctor
Consulting Doctor
PV1-10
Hospital Service
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
Not Required.
Syntax Notes
provider ID.
provider ID.
provider ID.
12
PV1-17
Admitting Doctor
This field is not

required when
used. This field is
used for athenaNet
provider routing
logic.
PV1-18
Patient Type
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.
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.
name
provider ID.
13
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.
PV1-52
Other Healthcare Provider
This field is not

required when
used. This field is
used for athenaNet
provider routing
logic.
name
provider ID.
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
14
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
Not Required.
ORC-12
Ordering Provider
This field is not

required when
another
provider-related
field is used.
This field is
used for
athenaNet
provider routing
logic.
ORC-13
Enterer's Location
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
Order Status Modifier
Not Required.
ORC-26
Advanced Beneficiary Notice

Override Reason
Not Required.
name
provider ID.
15
ORC-27
Filler's Expected Availability

Date/Time
Not Required.
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.
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.
16
Field
Element
Comments
OBR-1
Set ID - OBR
This field represents

the sequence number.
OBR-2
Placer Order Number
Not Required. This

field is the ordering
facilitys order
number.
OBR-3
Filler Order Number
Not Required. This

field is the order
fillers order number.
Also known as the
external accession
identifier, this field is
interpreted as the
Specimen/Accession
ID on a result
document.
OBR-4
Universal Service Identifier
This field represents

the code and
description. For
laboratory and
imaging results,
descriptions are
displayed in the chart.
code^description
OBR-5
Priority - OBR
A 1 indicates the
result is urgent.2 or
no value indicates the
result is not urgent.
1 or 2, 1 will indicate
the result is Urgent.
OBR-6
Requested Date/Time
Not Required.
OBR-7
Observation Date/Time
This field is
interpreted as the
Specimen Coll. Date
on a result document.
OBR-8
Observation End Date/Time
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
Not Required.
OBR-14
Specimen Received Date/Time
Used for backwards

compatibility. This
field is interpreted as
the Specimen Rec.
Date on a result
document.
Syntax Notes
17
OBR-15
Specimen Source
Used for backwards

compatibility. This
field is interpreted as
the Specimen Source
on a result document.
OBR-16
Ordering Provider
This field is not

required when
athenaNet provider
routing logic.
OBR-17
Order Callback Phone Number
Not Required.
OBR-18
Placer Field 1
Not Required. This

field is the default for
document-level PACS
link functionality
within athenaNet.
OBR-19
Placer Field 2
Not Required.
OBR-20
Filler Field 1
Not Required.
OBR-21
Filler Field 2
Not Required.
OBR-22
Results Rpt/Status Chng Date/Time
This field is
interpreted as the
Specimen Reported
Date on a result
document.
OBR-23
Charge to Practice
Not Required.
OBR-24
Diagnostic Serv Sect ID
Not Required.
OBR-25
Result Status
This field is used to

indicate the results
overall status. For a
list of the default
statuses, please see
the Observation and
Result Flags section.
OBR-26
Parent Result
Not Required.
OBR-27
Quantity/Timing
Not Required.
OBR-28
Result Copies To
This field is not

required when
athenaNet provider
routing logic.
OBR-29
Parent
Not Required.
OBR-30
Transportation Mode
Not Required.
providerid^lastname^
firstname
An NPI is preferred as
a provider ID.
providerid^lastname^
firstname
An NPI is preferred as
a provider ID.
18
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
Not Required.
OBR-38
Transport Logistics of
Collected Sample
Not Required.
OBR-39
Collector's Comment
Not Required.
OBR-40
Transport Arrangement
Responsibility
Not Required.
OBR-41
Transport Arranged
Not Required.
OBR-42
Escort Required
Not Required.
OBR-43
Planned Patient Transport

Comment
Not Required.
OBR-44
Procedure Code
Not Required.
OBR-45
Procedure Code Modifier
Not Required.
OBR-46
Placer Supplemental Service

Information
Not Required.
OBR-47
Filler Supplemental Service

Information
Not Required.
OBR-48
Medically Necessary
Duplicate Procedure Reason
Not Required.
OBR-49
Result Handling
Not Required.
OBR-50
Parent Universal Service

Identifier
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.
19
Field
Element
Comments
OBX-1
Set ID OBX
This field represents the sequence

number.
OBX-2
Value Type
This field contains the observation

value (OBX-5) format.
OBX-3
Observation Identifier
Required to indicate the name of

the analyte. The analyte name is
determined by the second
component.
OBX-4
Observation Sub-ID
Not Required.
OBX-5
Observation Value
This field is used to indicate the

Result field for an observation.
OBX-6
Units
This field is used to indicate the

Units of an observation.
OBX-7
References Range
This field is used as the Ref.

Range for an observation.
OBX-8
Abnormal Flags
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.
OBX-9
Probability
Not Required.
OBX-10
Nature of Abnormal Test
Not Required.
OBX-11
Observation Result
Status
This field will display the

observation or observation
fragments result status. For a list
of the default statuses, please see
the Observation and Result Flags
section.
OBX-12
Effective Date of
Reference Range Values
Not Required.
OBX-13
User Defined Access

Checks
Not Required.
OBX-14
Date/Time of the
Observation
Not Required.
OBX-15
Producer's Reference
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.
OBX-16
Responsible Observer
Not Required.
OBX-17
Observation Method
Not Required.
Syntax Notes
code^descriptio
n
20
OBX-18
Equipment Instance
Identifier
Not Required.
OBX-19
Date/Time of the
Analysis
Not Required.
OBX-20
Reserved for
harmonization with V2.6
Not Required.
OBX-21
Reserved for
Not Required.
OBX-22
Reserved for
Not Required.
OBX-23
Performing Organization
Name
This field is used to display the

performing facility information on
a result document.
OBX-24
Address

a result document.
OBX-25
Medical Director

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.
21
Field
Element
Comments
SPM-1
Set ID SPM
This field
represents the
sequence
number.
SPM-2
Specimen ID
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
Not Required.
SPM-8
Specimen Source Site
This field is
interpreted as
the Specimen
Source on a
result
document.
SPM-9
Specimen Source Site Modifier
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
Not Required.
SPM-18
Specimen Received Date/Time
This field is
interpreted as
the Specimen
Rec. Date on a
result
document.
SPM-19
Specimen Expiration Date/Time
Not Required.
SPM-20
Specimen Availability
Not Required.
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.
Syntax Notes
22
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
Comments
NTE-1
Set ID - NTE
This field represents the

sequence number.
NTE-2
Source of Comment
Not Required.
NTE-3
Comment
Textual comment to display.
NTE-4
Comment Type
Not Required.
Syntax Notes
4.0 Examples of Use

4.1 Amylase, Serum
23
MSH|^~\&|LAB|NASON|Athena|2964|20141023133254-0600||ORU^R01ÔRU_R01|20087.3|D|2.5.1|||AL|NE|||||
LRI_NG_RU_Profile^HL7^2.16.840.1.113883.9.19ÎSO
PID|1||V001047^^^&&ISO^MR^&&ISO~T00001059^^^&&ISO^XX^&&ISO~V00018739^^^&&ISOÂN^&&ISO||
test^michael^^^^^L||19870711|M||2131-1Ôther Race^HL70005|^^^^ÛSA^H|||||||||||||||||||N|||201410061026-0600|VVH^ÎSO
NTE|1|P|testing|RE^Remark^HL70364^C^Comment^L^2.5.1^V1
ORC|RE|1618-1^LAB.VVH^ÎSO|1023:RC00001R-1^LAB.VVH^ÎSO|1023:RC00001R^2060^ÎSO||N|||20141023133254-0600|||
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^81601ÛSA^B|
^WPN^PH^^1^970^3847590|Eagle Valley Medical Clinic^377 Sylvan Lake RoadÊagle^CO^81631ÛSA^B
OBR|1|1618-1^LAB.VVH^ÎSO|1023:RC00001R-1^LAB.VVH^ÎSO|AMYÂMYLASE^L^^^^2.40^1.2ÂMYLASE| ||2014102313220600|201410231322-0600||scj|O|||201410231510-0600||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|AMYÂMYLASE^L^^^^2.40^1ÂMYLASE||1002|U/Lênzyme unit per literÛCUMÛ/LÛ/L^L|25-115|H|||C|||
201410231322-0600|ML^Main Lab^L|A^ÂMYLASEÂMYLASE^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^81601ÛSA^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|||||||||||||201410231322-0600^201410231322-0600|
201410231510-0600||||||||0.1|^GREEN GEL (LI)
4.2 Rapid Strep Group A, Throat

Test^michael^^^^^L||19870711|M||2131-1Ôther Race^HL70005|^^^^ÛSA^H|||||||||||||||||||N|||201410280855-0600|VVH^ÎSO
NTE|1|P|Message Testing from Lab|RE^Remark^HL70364^C^Comment^L^2.5.1^V1
ORC|RE|1718-1^LAB.VVH^ÎSO|14:MR0005021R-1^LAB.VVH^ÎSO|14:MR0005021R^2149^ÎSO||N|||201411071248-0600|||
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|
OBR|1|1718-1^LAB.VVH^ÎSO|14:MR0005021R-1^LAB.VVH^ÎSO|GAS^GRP A STREP SCREEN-RAPID^L^GAS^GRP A STREP
SCREEN-RAPID^L^2.40^^GRP A STREP SCREEN-RAPID|||201411071244-0600|201411071244-0600||scj|O|||201411071356-0600||
24
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
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|ÊIA TEST MIC
4.3 Culture with Sensitivity Panel
athenaNet creates unique result documents for cultures and their sensitivity panels. It is recommended to use a TXtype OBX segment at the beginning of the sensitivity panel OBR to indicate the organism that is associated to the
panel.
Test^michael^^^^^L||19870711|M||2131-1Ôther Race^HL70005|^^^^ÛSA^H|||||||||||||||||||N|||201410280855-0700|VVH^ÎSO
ORC|RE|1720-1^LAB.VVH^ÎSO|14:AR0009135R-1^LAB.VVH^ÎSO|14:AR0009135R^2151^ÎSO||N|||201411180911-0700|||
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|
OBR|1|1720-1^LAB.VVH^ÎSO|14:AR0009135R-1^LAB.VVH^ÎSO|XXUCÛRINE CULTURE^L^XXUCÛRINE
CULTURE^L^2.40^ÛRINE CULTURE| ||201411071405-0600|201411071405-0600||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
25
TQ1|1||||||201411071405-0700|201411071405-0700|R
OBX|1|CWE|^^^^^^^ÛRINE CULTURE|1|ESCHERICHIA COLIÔ:EC-1^LÊC-1ÊSCHERICHIA
COLI^L^2014111809^ÊSCHERICHIA COLI|||||||||201411071405-0700|ML^Main Lab||||201411180910-0700||||Main
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^ÎSO|14:AR0009135R-2^LAB.VVH^ÎSO|XXMSNÎD/MIC NEG^L^XXMSNÎD/MIC NEG^L^2.40^ÎD/MIC
NEG| ||201411071405-0600|201411071405-0600||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|||1720-1&LAB.VVH&&ISO^14:AR0009135R-1&LAB.VVH&&ISO|||27097&UNKNOWN&U&Lauck&Susan&&&&&&ISO
OBX|1|TX|||Organism: ESCHERICHIA||||||F
OBX|2|SN|AMÂMPICILLIN^LÂMÂMPICILLIN^L^2.40^ÂMPICILLIN|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^81601ÛSA^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^81601ÛSA^B|^Refior^Jeanette^^^^^^NPI&2.16.840.1.113883.4.6&ISO^L^^^NPI^VVH&&ISO
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
26
OBX|13|ST|VANI_1^VANCOMYCIN (IV)|1|<=2 S1 |||S|||F||||WL|515|||201411121138

OBX|14|ST|AMPI_1ÂMPICILLIN (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)
5.0 Change Log
5.1 New Segment Support
athenahealths 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.
27
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.
28

ORU Specification and Sample Messages

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ORU Specification and Sample Messages

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Inbound Observation

Inbound Observation Reporting Interface Specifications

2.0 HL7 ORU MESSAGE SPECIFICATIONS...............................................................................4

MSH MESSAGE HEADER SEGMENT............................................................................................................. 5

4.0 EXAMPLES OF USE....................................................................................................... 18

5.0 CHANGE LOG............................................................................................................... 22

athenahealth, Inc. Confidential and Proprietary

Inbound Observation Reporting Interface Specifications

1.3 athenaNet Message Exchange (MX) Engine

1.4 HL7 Message Versioning

2.0 HL7 ORU Message Specifications

2.1 Trigger Events

athenahealth, Inc. Confidential and Proprietary

Inbound Observation Reporting Interface Specifications

2.2 Message Definition

Notes and Comments

Next of Kin/Associated Parties

Patient Visit Additional Info

Notes and Comments

Timing/Quantity Order Sequence

Notes and Comments

Clinical Trial Identification

Observation Related to Specimen

2.3 Message Format

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Inbound Observation Reporting Interface Specifications

3.0 Segment Mappings

3.1 MSH Message Header Segment

athenahealth, Inc. Confidential and Proprietary

Inbound Observation Reporting Interface Specifications

Required. This field

The expected value is |,

Required. This field

The expected values are

Required. This field

LAB, RAD, or TRN are

Required. This field

An identifier for the

Required. This field

Required. Date and

athenahealth, Inc. Confidential and Proprietary

Inbound Observation Reporting Interface Specifications

Required. This field

Required. This field

Accept Acknowledgment Type

Application Acknowledgement Type

Principal Language of Message

Alternate Character Set Handling

Message Profile Identifier

2.5.1 or HL7 message

3.2 PID Patient Identification Segment

athenahealth, Inc. Confidential and Proprietary

Inbound Observation Reporting Interface Specifications

Patient Identifier List

Alternate Patient ID - PID

The patient name is

Mothers Maiden Name

The patient date of

Not Required. Utilized

Not Required. Utilized

Phone Number - Home

Not Required. Utilized

Phone Number - Business

Patient Account Number