The HL7 ORU-R01 message transmits observations and results from the producing system/filler i.e. LIS, EKG system) to the ordering system/placer (i.e. HIS, physician office application). It may also be used to transmit result data from the producing system to a medical record archival system, or to another system not part of the original order process. ORU messages are also sometimes used to register or link to clinical trials, or for medical reporting purposes for drugs and devices.

Types of observations reported in the ORU-R01 message include:

  • Clinical lab results
  • Imaging study reports
  • EKG pulmonary function study results
  • Patient condition or other data (i.e. vital signs, symptoms, allergies, notes, etc.)

The ORU message is a structured report where each observation is separated into an individual entity, and then separated into fields. ORU messages do not carry images; they use varying data types but most often use text, numbers and codes.

In the ORU message, the OBR (Observation request) and OBX (Observation) segments are most significant due to their functions:

  • The HL7 OBR segment is used in all ORU messages as a report header, and contains important information about the order being fulfilled (i.e. order number, request date/time, observation date/time, ordering provider, etc.). This segment is part of a group that can be used more than once for each observation result that is reported in the message.
  • The HL7 OBX segment transmits the actual clinical observation results as a single observation or observation fragment. OBX segments can also be used more than once in the message, and may be followed by one or more NTE segments to provide additional notes and comments about the observation.
  • The segments and groups of segments in the ORU-R01 message include the following:

    SEGMENT/GROUPNAMEOPTIONAL/REPEATABLE?
    MSHMessage headerRequired
    ResultsGroup – Repeatable group, includes groups that follow (unless otherwise noted):
    PatientGroup – Optional group
    PIDPatient identificationRequired
    PID1Patient demographicsOptional
    NTENotes and commentsOptional, Repeatable
    PatientVisitGroup – Optional group, part of PatientGroup
    PV1Patient visitRequired
    PV2Patient visit – additional infoOptional
    OrderGroup – Repeatable group
    ORCCommon orderOptional
    OBRObservation requestRequired
    NTE-1Notes and commentsOptional, Repeatable
    ObservationGroup –Repeatable group, part of OrderGroup
    OBXObservationOptional
    NTE-2Notes and commentsOptional, Repeatable
    OrderGroup continued
    CTIClinical trial identificationOptional, Repeatable
    Additional segment, not part of a group:
    DSCContinuation pointer segmentOptional

    In HL7 pipe and hat format, an ORU-R01 message would look like this (each OBR segment is shown in blue, each OBX segment is shown in red):


    MSH|^~\&|LCS|LCA|LIS|TEST9999|199807311532||ORU^R01|3629|P|2.2
    PID|2|2161348462|20809880170|1614614|20809880170^TESTPAT||19760924|M|||^^^^
    00000-0000|||||||86427531^^^03|SSN# HERE
    ORC|NW|8642753100012^LIS|20809880170^LCS||||||19980727000000|||HAVILAND
    OBR|1|8642753100012^LIS|20809880170^LCS|008342^UPPER RESPIRATORY
    CULTURE^L|||19980727175800||||||SS#634748641 CH14885 SRC:THROA
    SRC:PENI|19980727000000||||||20809880170||19980730041800||BN|F

    OBX|1|ST|008342^UPPER RESPIRATORY CULTURE^L||FINALREPORT|||||N|F||| 19980729160500|BN
    ORC|NW|8642753100012^LIS|20809880170^LCS||||||19980727000000|||HAVILAND
    OBR|2|8642753100012^LIS|20809880170^LCS|997602^.^L|||19980727175800||||G|||
    19980727000000||||||20809880170||19980730041800|||F|997602|||008342

    OBX|2|CE|997231^RESULT 1^L||M415|||||N|F|||19980729160500|BN
    NTE|1|L|MORAXELLA (BRANHAMELLA) CATARRHALIS
    NTE|2|L| HEAVY GROWTH
    NTE|3|L| BETA LACTAMASE POSITIVE
    OBX|3|CE|997232^RESULT 2^L||MR105|||||N|F|||19980729160500|BN
    NTE|1|L|ROUTINE RESPIRATORY FLORA

    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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