The HL7 ORM-O01 message functions as a general order message that is used to transmit information about an order. There is only one type of ORM message – the ORM-O01 message. Trigger events for the ORM-O01 message involve changes to an order such as new orders, cancellations, information updates, discontinuation, etc. ORM messages are among the most widely used message types in the HL7 standard.

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An order can be defined as a “request for service” that is sent between applications, or in some cases within a single application (an application can send orders to itself). An ORM message is composed of segments and groups of segments, each of which may be required, optional, repeatable, or a combination of these (see HL7 cardinality).

The segments and groups of segments in the ORM-O01 message include the following:

SEGMENT/GROUPNAMEOPTIONAL/REPEATABLE?
MSHMessage headerRequired
NTENotes and commentsOptional, Repeatable
PatientGroup – Optional group (Required for new orders pertaining to a patient only)
PIDPatient identificationRequired
PID1Patient demographicsOptional
NTE-1Notes and commentsOptional, Repeatable
PatientVisitGroup – Optional group, part of PatientGroup
PV1Patient visitRequired
PV2Patient visit – additional infoOptional
InsuranceGroup – Optional and repeatable group, part of PatientGroup
IN1InsuranceRequired
IN2Insurance additional infoOptional
IN3Insurance additional info certificationOptional
PatientGroup continued
GT1GuarantorOptional
AL1Patient allergy informationOptional, Repeatable
OrderGroup – Repeatable group
ORCCommon orderRequired
OrderDetailGroup – Optional group, part of OrderGroup
OBRObservation requestRequired
NTE-2Notes and commentsOptional, Repeatable
DG1DiagnosisOptional, Repeatable
ObservationGroup – Optional and Repeatable, part of OrderDetailGroup
OBXObservationRequired
NTE-3Notes and commentsOptional, Repeatable
OrderGroup continued
CTIClinical trial identificationOptional
BLGBillingOptional

Like ADT messages, ORM messages contain a PID segment to provide patient identification information. However in the ORM message, this segment is only required in the case of new orders and only if the new order is related to a particular patient. Unless both of these conditions are met, the PID segment will not be included in the message.

The OBX (Observation) segment also has a special function in the ORM message when compared to its use in other message types, such as the ORU (Observational Report – Unsolicited) message. In the ORM message, the OBX segment is part of an optional and repeatable group called the Observation group. When used, it carries clinical information that might be needed by the receiving system to interpret the observation that will be made, rather than information about observations and results (as in the ORU message).

In HL7 pipe and hat format, an ORM message would look like this:


MSH|^~\&|HIS|MedCenter|LIS|MedCenter|20060307110114||ORM^O01|MSGID20060307110114|P|2.3
PID|||12001||Jones^John^^^Mr.||19670824|M|||123 West St.^^Denver^CO^80020^USA|||||||
PV1||O|OP^PAREG^||||2342^Jones^Bob|||OP|||||||||2|||||||||||||||||||||||||20060307110111|
ORC|NW|20060307110114
OBR|1|20060307110114||003038^Urinalysis^L|||20060307110114

Additional information can be found on the HL7 Standards resource site or visit the Corepoint Health blog for additional insights and observations on healthcare IT news.

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