Radiology

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1 ORU R01: Send radiology reports to PKB

ORU R01: Send radiology reports to PKB

Overview

The ORU R01 message can be used to send radiology reports, and will appear in the "Imaging" tab in the PKB web interface.

Note: we detect radiology data based on MSH-3. It must be "RADIOLOGY", or else another radiology system on our list (let us know what you use and we'll add it to our list).

Content patterns

A "content pattern" indicates how PKB will interpret the contents of your message. This provides additional guidance over and above the syntactic requirements of individual segments.

PKB only supports one content pattern for radiology reports.

Single HTML report with multiple embedded image attachments

The OBR group can contain multiple OBX and NTE segments.

If an OBX segment contains an image (OBX-2.1 = ED and OBX-5.2 = IM) then the image will be extracted and added as an attachment to the final radiology report. The location and ordering of OBX segments containing images is not considered meaningful.

An NTE segment, or an OBX segment which does not contain an image, is considered to contain a portion of the radiology report. The ordering of these segments will be respected, but they do not maintain an identity in their own right. They will be concatenated together to form a single HTML radiology report.

Note: If you wish to apply a patient delay this must be provided in the first segment.

Relevant entities

Radiology information is used to populate [[Radiology Report]] entities

Please click through to the Data Model to explore the presentation of these entities in the web interface.

Update Behaviour

Message	Entity	Matching Criteria	Behaviour (Matched)	Behaviour (Not Matched)
R01	[[Radiology Report]]	[[Radiology Report.External ID]] as derived from ORC-3.1 or OBR-3.1	The existing [[Radiology Report]] is replaced in its entirety. A partial update is not performed.	New [[Radiology Report]] created.

Definition

Segment	Field	Component	Description	Example	Data Model
MSH			Message header. This conforms to PKB's standard definition.
PID			Patient identification. This conforms to PKB's standard definition.
[ PV1 ]			This is used to include the relevant Hospital Service Code.
	[ PV1-10 ]		Hospital service. See here for more information on code sets.
		PV1-10.1	Hospital service code		[[Radiology Report.Specialty]]
[ ORC ]			Common order
	[ ORC-3 ]		Filler order number. This will be overridden by OBR-3.1 if present. At least one of either ORC-3.1 or OBR-3.1 must be provided.
		ORC-3.1	Filler order number	MYORDER0001	[[Radiology Report.External ID]] if OBR-3 was not provided
	[ ORC-13 ]		Enterer's Location
		ORC-13.9	Description	Laboratory 1	[[Radiology Report.Enterer Location]]
OBR			Observation request
	[ OBR-3 ]		Filler order number. If present, this will override any value in ORC-3.1. At least one of either ORC-3.1 or OBR-3.1 must be provided.
		OBR-3.1	Filler order number	MYORDER0001	[[Radiology Report.External ID]]
	[ OBR-4 ]		Universal service identifier. This is used to set the title of the report. The message will be rejected if neither OBR-4.2 nor OBR-4.5 contains a name. See here for more information on code sets.
		[ OBR-4.2 ]	Service name	CHEST XRAY	[[Radiology Report.Title]]
		[ OBR-4.5 ]	Alternative service name	XRAY (CHEST)	[[Radiology Report.Title]] if OBR-4.2 was not provided
	OBR-7		This is mandatory for radiology reports.
		OBR-7.1	Observation timestamp	201505191657	[[Radiology Report.Timestamp]]
	[ OBR-16 ]		Ordered by. If present, at least the family name must be given.		[[Radiology Report->Source.Source Text]]
		OBR-16.2	Family name	Foster
		[ OBR-16.3 ]	Given name	John
		[ OBR-16.4 ]	Middle names	Harry
		[ OBR-16.6 ]	Title	Dr
	[ OBR-25 ]		Result status. If a value of R is provided: any radiology reports received previously for this report ID will be marked as deleted. OBX segments are not required and will be ignored. Otherwise: the report is processed as documented.
		OBR-25.1	Result status	F
{ [ NTE ] }			NTE segments can be used to include comments.
	NTE-3		Comment
		NTE-3.1	Comment	This is a comment.	These OBR-level comments are set in [[Radiology Report.Description]]
{ OBX			Observation or result
	OBX-2		Value type. Radiology messages only support: FT, TX or ED.
		OBX-2.1	Value type	ED
	OBX-3		Observation identifier. Although both names are individually optional, the message will be rejected if neither OBR-4, nor any OBX-3, contains a name. See here for more information on code sets.
		[ OBX-3.2 ]	Test name	CHEST XRAY	[[Radiology Report.Title]] if OBR-4 was not provided and this is the first OBX with a name. In addition, [[Radiology Report->Attachment.Filename]] will be set if an attachment is created. If a test name was not provided, then the attachment filename is set to radiology<timestamp_in_millis>.<lowercase_OBX-5.3>
		[ OBX-3.5 ]	Alternative test name	XRAY (CHEST)	[[Radiology Report.Title]] if OBR-4 was not provided, this is the first OBX with a name, and OBX-3.2 was not provided. In addition, [[Radiology Report->Attachment.Filename]] will be set if an attachment is created and OBX-3.2 was not provided. If a test name was not provided, then the attachment filename is set to radiology<timestamp_in_millis>.<lowercase_OBX-5.3>
	OBX-5		Test result value. Field contents vary based on value type (OBX-2.1). Currently, we only support TEXT/HTML and IM/* data types for ED values.
		[ OBX-5.1 ]	Application (if OBX-2.1 = ED); Value (otherwise)	APP	If the OBX does not contain an image attachment, then this value is appended to [[Radiology Report.Description]]
		[ OBX-5.2 ]	Data type (if OBX-2.1 = ED)	IM
		[ OBX-5.3 ]	Sub-data type (if OBX-2.1 = ED)	TIFF	[[Radiology Report->Attachment.Media Type]]
		[ OBX-5.4 ]	Encoding (if OBX-2.1 = ED)	Base64
		[ OBX-5.5 ]	Value (if OBX-2.1 = ED)	JVi0xLjMKJeTjz ...	For ED data, this value is set in [[Radiology Report->Attachment.Content]] after being decoded according to OBX-5.4
	OBX-11		Result status. Only values of F and C will be processed. Values of I, O, P or X (which indicate pending or no results) are silently ignored, whilst any other values will cause an error.
		OBX-11.1	Result status	F
	[ OBX-13 ]		Custom access rules. Currently supported: "{patientDelay:NUMBERdays}" with any whole number in place of "NUMBER" (no spaces). The patient will see that a radiology report has arrived, but the result value will not be revealed until the set number of days past the date/time of observation have passed. If this field is not specified the patient will be able to see their report immediately.
		OBX-13.1	Custom access rules	{patientDelay:3days}
{ [ NTE ] } }			NTE segments can be used to include comments.
	NTE-3		Comment
		NTE-3.1	Comment	This is a comment.	Finally, any OBX-level comments are also appended to [[Radiology Report.Description]]

Examples

An example message containing a radiology image.

MSH|^~\&|RADIOLOGY|SendingFacility|HL7API|PKB|20160102101112||ORU^R01|ABC0000000001|P|2.4

PID|||9999999999^^^NHS^NH||Smith^John^Joe^^Mr||19700101|M|||My flat name^1, The Road^London^London^SW1A 1AA^GBR||john.smith@hotmail.com^NET~01234567890^PRN~07123456789^PRS|john.smith@company.com^NET~01234098765^WPN||||||||||||||||N|

OBR|1|P123|F123|500^CHEST XRAY^L||201408080948|201408080000||||||||||||||||||F

OBX|1|ED|502^CHEST XRAY^L||^IM^TIFF^Base64^JVi0xLjMKJeTjz9IKNAw (more bytes...)||||||F|||201408080000

Response

PKB will respond with a standard HL7 acknowledgement.

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