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The Observation Result (ORU) section provides guidance on single results, textual results, microbiology reports, and radiology reports.

Unique Identifier for Laboratory Reports

Orion Health solutions identify laboratory reports using a combination of fields that remain unique throughout the life cycle of the laboratory report. The unique identifier ensures that updates to existing laboratory reports or changes in the status of the report are correctly reflected in the solution.

Single, Textual, and Radiology reports are uniquely identified using a combination of the following fields:

  • OBR.3 Filler Order Number
  • OBR.2 Placer Order Number
  • OBR.4 Universal Service ID

Microbiology reports are uniquely identified using a combination of the following fields:

  • OBR.3 Filler Order Number
  • OBR.2 Placer Order Number

Laboratory Result Attachments

A laboratory report may have one or more attachments of the following types:

  • PDF file – PDF documents must have a subtype of PDF but can have a type of TEXT, IM, or AP depending on the content of the file. For example, if the PDF is an image from an imaging application, the type must be IM. If it is text, or text and other objects, the type must be TEXT
  • Image file – Images must be in the JPEG or TIFF format

An attachment is usually associated with a particular observation test or the report in general. In HL7 v2, attachments are represented as individual OBX segments with a data type of Encapsulated Data (ED).

A report is required to store enough information so that a consuming application can interpret the format of the attachment, ascertain the observation test that it is associated with if any, and locate the attachment. The information that indicates the type and format of the data is specified in OBX.5.2 and OBX.5.3 in accordance with the values defined in HL70191 and HL70291.

Attachments are only supported for Textual and Radiology results.

Relationship — Parent and Child Reports

When an ORU message is processed, OBR segments are stored as laboratory reports, with the associated OBX segments stored as laboratory results within the report.

Microbiology Reports

If an OBR is processed as a Microbiology report and OBR.29 Parent Number is present, it is treated as a child report. It is linked to the parent record in the database. If the parent record cannot be found, the message is rejected. The clinical event fired as a result of processing this report will relate to the parent report.

If OBR.26 Parent Result is present and the solution is configured to validate parent result links, the child report is linked to the parent result in the database. If the parent result does not exist, the message is rejected.

Other Report Types

If an OBR is processed as a report type that is not Microbiology, the parent identifier is stored but not validated. It is not linked to the parent report even if it exists. The clinical event fired will relate to the report that was processed.

If OBR.26 Parent Result is present, the identifier is stored but not validated. The child report is not linked to its parent result.

This has been done because parent and child relationships in Microbiology can be viewed as one super record. The child report is part of the parent report and has no meaning when separated. Parent and child relationships in other report types are not understood well enough to be validated.


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