Introduction
This changelog documents all modifications, additions, and clarifications made to the OML (Order Message List) specification during the transition from version 2 to version 3. The OML message encompasses all HL7 segments needed to transmit diagnostic test orders, including message headers, patient demographics, insurance, ordering details, specimens, and observations. The changes are categorized into three types:
- Unchanged: Elements that retain the same structure and semantics across versions
- Modified: Elements where the content, format, or interpretation has changed
- New: Elements introduced for the first time in v3
- Renumbered/Relocated: Elements that have moved positions or been reorganized
The message header remains stable across versions, maintaining compatibility with HL7 v2.5.1 standards.
| Field | V2 | V3 | Change |
|---|
| MSH-1 | Field Separator | | Field Separator | | Unchanged |
| MSH-2 | Encoding Characters ^~\& | Encoding Characters ^~\& | Unchanged |
| MSH-3.1 | Sending Application: “ZorgDomein” | Sending Application: “ZorgDomein” | Unchanged |
| MSH-5.1 | Receiving Application name | Receiving Application name | Unchanged |
| MSH-6.1 | Receiving Facility name | Receiving Facility name | Unchanged |
| MSH-7.1 | Date/Time of Message (yyyyMMddHHmmss+HHmm) | Date/Time of Message (yyyyMMddHHmmss+HHmm) | Unchanged |
| MSH-9.1 | Message Type: “OML” | Message Type: “OML” | Unchanged |
| MSH-9.2 | Trigger Event: “O21” | Trigger Event: “O21” | Unchanged |
| MSH-9.3 | Message Structure: “OML_O21” | Message Structure: “OML_O21” | Unchanged |
| MSH-10 | Message Control ID (unique identifier) | Message Control ID (unique identifier) | Unchanged |
| MSH-11.1 | Processing ID: “P” | Processing ID: “P” | Unchanged |
| MSH-12.1 | Version ID: “2.5.1” | Version ID: “2.5.1” | Unchanged |
| MSH-17 | Country Code: “NLD” | Country Code: “NLD” | Unchanged |
| MSH-18 | Character Set: “8859/1” | Character Set: “8859/1” | Unchanged |
PID Segment: Patient Identification
Patient demographic data undergoes minor enhancements in V3 to support email addresses and clarify address type indicators.
Patient Identifiers (PID-3)
| Field | V2 | V3 | Change |
|---|
| PID-3.1 (BSN) | Patient’s BSN with 3.4.1=“NLMINBIZA” 3.5=“NNNLD” | Patient’s BSN with 3.4.1=“NLMINBIZA” 3.5=“NNNLD” | Unchanged |
| PID-3.1 (XIS ID) | XIS patient ID with 3.5=“PI” | XIS patient ID with 3.5=“PI” | Unchanged |
| PID-3.1 (ZorgDomein) | ZorgDomein patient ID with 3.5=“PI” | ZorgDomein patient ID with 3.5=“VN” | Unchanged semantically |
| Note | — | When BSN is missing, PID-3 is not sent in V3 | New behavior in V3 |
Patient Name & Demographics
| Field | V2 | V3 | Change |
|---|
| PID-5 (Name fields) | Full surname, surname prefixes, spouse surname, first initial, other initials, family name indicator | Full surname, surname prefixes, spouse surname, first initial, other initials, family name indicator | Unchanged |
| PID-7.1 | Date of birth (yyyyMMdd) | Date of birth (yyyyMMdd) | Unchanged |
| PID-8 | Administrative Sex: “M”/“F”/“O”/“U” | Administrative Sex: “M”/“F”/“O”/“U” | Unchanged |
Patient Address (PID-11)
| Field | V2 | V3 | Change |
|---|
| PID-11.1–11.7 | Street, dwelling, other designation, city, postal code, country, address type | Street, dwelling, other designation, city, postal code, country, address type | Modified |
| PID-11.7 Indicator | Always “M” (mailing) in V2 | “M” (mailing) or “C” (home address) in V3 | V3 distinguishes between mailing and home addresses when applicable |
Impact: V3 enables more precise address type classification, allowing systems to differentiate between mailing and residential addresses.
| Field | V2 | V3 | Change |
|---|
| PID-13 (Phone) | 13.1=number, 13.2=“PRN”, 13.3=“PH” | 13.1=number, 13.2=“PRN”, 13.3=“PH” | Unchanged |
| PID-13 (Mobile) | 13.1=number, 13.2=“ORN”, 13.3=“CP” | 13.1=number, 13.2=“ORN”, 13.3=“CP” | Unchanged |
| PID-13 (Email - V3 New) | (Not present in V2) | 13.2=“NET”, 13.3=“Internet”, 13.4=email address | New in V3 |
Impact: V3 adds email address as an optional contact field, enabling direct digital communication channels.
Patient Other Fields
| Field | V2 | V3 | Change |
|---|
| PID-31 | Identity Unknown Indicator: “Y”/“N” | Identity Unknown Indicator: “Y”/“N” | Unchanged |
| PID-32 | Identity Reliability Code: “NNNLD” | Identity Reliability Code: “NNNLD” | Unchanged |
PV1 Segment: Patient Visit
PV1 remains mostly unchanged in V3, with reserved fields added for future patient location tracking.
| Field | V2 | V3 | Change |
|---|
| PV1-1 | Set ID: “1” | Set ID: “1” | Unchanged |
| PV1-2 | Patient Class: “O” (outpatient) | Patient Class: “O” (outpatient) | Unchanged |
| PV1-3.1 | (Not present) | Assigned Patient Location – Department name (reserved for future use) | New in V3 |
| PV1-3.2 | (Not present) | Room number (reserved for future use) | New in V3 |
| PV1-3.6 | (Not present) | “D” (reserved for future use) | New in V3 |
| PV1-3.9 | (Not present) | Full location description (reserved for future use) | New in V3 |
| PV1-51 | Visit Indicator: “V” | Visit Indicator: “V” | Unchanged |
Impact: V3 reserves location fields for future enhancements, enabling more granular patient location tracking when needed.
PV2 contains a single, important coding system change aligned with HL7 standards.
| Field | V2 | V3 | Change |
|---|
| PV2-3.1 | Admit Reason – Code of healthcare product | Admit Reason – Code of healthcare product | Unchanged semantics |
| PV2-3.2 | Name of healthcare product | Name of healthcare product | Unchanged |
| PV2-3.3 | Coding system: 99zda | Coding system: L | Modified |
Key Change: V2’s fixed value 99zda (ZorgDomein) is replaced with L (HL7 standard local code marker), aligning with international HL7 v2.x conventions.
IN1 Segment: Insurance
Insurance information remains stable, with no structural changes between V2 and V3.
| Field | V2 | V3 | Change |
|---|
| IN1-1 | Set ID: “1” | Set ID: “1” | Unchanged |
| IN1-2.2 | Insurance Plan ID: “null” | Insurance Plan ID: “null” | Unchanged |
| IN1-3.1 | Insurance Company ID (UZOVI or “0”) | Insurance Company ID (UZOVI or “0”) | Unchanged |
| IN1-3.4.1 | Coding: “VEKTIS” (if UZOVI) or “LOCAL” | Coding: “VEKTIS” (if UZOVI) or “LOCAL” | Unchanged |
| IN1-3.5 | Identifier Type: “UZOVI” | Identifier Type: “UZOVI” | Unchanged |
| IN1-4.1 | Insurance Company Name | Insurance Company Name | Unchanged |
| IN1-36 | Policy Number | Policy Number | Unchanged |
ORC Segment: Order Common
ORC undergoes significant refinement in V3, including format relaxation, coding system updates, and new address/contact fields for the ordering facility.
Order Control & Numbering
| Field | V2 | V3 | Change |
|---|
| ORC-1 | Order Control: “NW”, “CA”, “RO”, “XO” | Order Control: “NW” (active), “CA” (reserved), “XO” (reserved) | V3 marks “CA” (cancel) and “XO” (change) as reserved; “RO” (replacement) is no longer used |
| ORC-2.1 | Placer Order Number (ZDnnnnnnnnn_nn format) | Placer Order Number (10–20 alphanumeric characters) | Format relaxed: V3 allows any 10–20 character alphanumeric string |
| ORC-3.1 | Filler Order Number | Filler Order Number | Unchanged |
| ORC-4.1 | Placer Group Number (overarching ZD ID) | Placer Group Number (sub-request ID: ZD + suffix) | V3 redefines as “sub-request ID,” enabling finer granularity |
Priority & Timing
| Field | V2 | V3 | Change |
|---|
| ORC-7.6 | (Not present in V2) | Quantity/Timing – Priority code (per HL7 table 0485) | New in V3 |
Transaction Timestamp & Personnel
| Field | V2 | V3 | Change |
|---|
| ORC-9.1 | Date/Time of Transaction (yyyyMMddHHmmss+HHmm) | Date/Time of Transaction (yyyyMMddHHmmss+HHmm) | Unchanged |
| ORC-10.1 | Entered By – Acting referrer’s AGB-code | Entered By – Acting referrer’s AGB-code | Unchanged |
| ORC-10.2.1 | Acting Referrer’s Full Surname | Acting Referrer’s Full Surname | Unchanged |
| ORC-10.3 | Acting Referrer’s Initials | Acting Referrer’s Initials | Unchanged |
| ORC-10.9.1 | Coding system: “VEKTIS” | Coding system: “VEKTIS” | Unchanged |
Ordering Provider (Responsible Referrer)
| Field | V2 | V3 | Change |
|---|
| ORC-12.1 | Responsible Referrer’s AGB-code | Responsible Referrer’s AGB-code | Unchanged |
| ORC-12.2.1 | Responsible Referrer’s Full Surname | Responsible Referrer’s Full Surname | Unchanged |
| ORC-12.3 | Responsible Referrer’s Initials | Responsible Referrer’s Initials | Unchanged |
| ORC-12.9.1 | Coding system: “VEKTIS” | Coding system: “VEKTIS” | Unchanged |
Enterer’s Location (Acting Referrer’s Practice/Location)
| Field | V2 | V3 | Change |
|---|
| ORC-13.4.1 | Name of acting referrer’s practice | (Renumbered) | Moved to ORC-13.9 |
| ORC-13.4.2 | AGB-code of acting referrer’s practice | (Renumbered) | Moved to ORC-13.10.1 |
| ORC-13.9 | Name of Acting Referrer’s Location | Name of Acting Referrer’s Location | Unchanged |
| ORC-13.10.1 | (Not in V2) | AGB-code of acting referrer’s location | New position in V3 |
| ORC-13.10.2 | (Not in V2) | Coding system: “VEKTIS” | New in V3 |
Impact: Fields renumbered for HL7 alignment; coding system added for consistency.
Call Back Phone Number (ORC-14)
| Field | V2 | V3 | Change |
|---|
| ORC-14.1 | Phone number for results | Phone number for results | Unchanged |
| ORC-14.2 | Discriminator: “WPN” | Discriminator: “WPN” | Unchanged |
| ORC-14.3 | Discriminator: “PH” (phone) | Discriminator: “PH” (phone) | Unchanged |
| ORC-14 (Fax) | (Separate option) | Fax discriminator: “FX” in same series | Clarified in V3 |
Order Effective Date/Time
| Field | V2 | V3 | Change |
|---|
| ORC-15 | Order Effective Date/Time (for CA, RO, XO) | Order Effective Date/Time (for CA, XO only) | V3 removes “RO” (replacement) from applicable control codes |
Entering Organization (Ordering Facility)
| Field | V2 | V3 | Change |
|---|
| ORC-17.1 | Entering Organization AGB-code | Entering Organization AGB-code | Unchanged |
| ORC-17.2 | Name of Acting Referrer’s Practice | Name of Acting Referrer’s Organization | Unchanged semantics |
| ORC-17.3 | Coding system: “VEKTIS” | Coding system: “VEKTIS” | Unchanged |
| Field | Description | Type | Coding |
|---|
| ORC-22.1.1 | Street name | Text | — |
| ORC-22.1.2 | Street dwelling number | Text | — |
| ORC-22.1.3 | Other designation | Text | — |
| ORC-22.2 | City name | Text | — |
| ORC-22.5 | Postal code | Text | — |
| ORC-22.6 | Country code | Text | — |
| ORC-23.1 | Phone number for ordering facility location | Text | — |
| ORC-23.2 | Discriminator: “WPN” | — | — |
| ORC-23.3 | Discriminator: “PH” (phone) or “FX” (fax) | — | — |
Impact: V3 introduces complete address and contact information for the ordering facility, enabling direct communication and location identification.
Action By (Person Responsible for Updates)
| Field | V2 | V3 | Change |
|---|
| ORC-19.1 | Responsible Updater’s AGB-code | Responsible Updater’s AGB-code | Unchanged |
| ORC-19.2.1 | Responsible Updater’s Full Surname | Responsible Updater’s Full Surname | Unchanged |
| ORC-19.3 | Responsible Updater’s Initials | Responsible Updater’s Initials | Unchanged |
| ORC-19.9.1 | Coding system: “VEKTIS” | Coding system: “VEKTIS” | Unchanged |
Ordering Facility Name (Responsible Referrer’s Organization)
| Field | V2 | V3 | Change |
|---|
| ORC-21.1 | Ordering Facility Name | Ordering Facility Name | Unchanged |
| ORC-21.3 | Ordering Facility AGB-code | Ordering Facility AGB-code | Unchanged |
| ORC-21.6.1 | Coding system: “VEKTIS” | Coding system: “VEKTIS” | Unchanged |
TQ1 Segment: Timing/Quantity
TQ1 enhances priority handling by aligning with HL7 standard coding tables instead of custom values.
| Field | V2 | V3 | Change |
|---|
| TQ1-1 | Set ID: “1” (matches OBR-1) | Set ID: “1” (matches OBR-1) | Unchanged |
| TQ1-7.1 | Start date/time for sampling (earliest if TQ1-8.1 present) | Start date/time for sampling (earliest date) | Unchanged semantics |
| TQ1-8.1 | End date/time – Latest date for sampling | End date/time – Latest date for sampling | Unchanged |
| TQ1-9.1 | Priority: “S” (urgent) or “R” (routine) | Priority code per HL7 table 0485 | Modified: V3 uses HL7 standard codes instead of custom values |
| TQ1-9.2 | (Not in V2) | Priority label (text description of code) | New in V3 |
| TQ1-9.3 | (Not in V2) | Coding system: “HL70485” | New in V3 |
| TQ1-11 | Text instruction for collection employee | Text instruction for collection employee | Unchanged |
Impact: V3 standardizes priority coding using HL7 table 0485, enabling better interoperability with international systems.
OBR Segment: Observation Request
OBR undergoes substantial refinement, with coding system standardization, format flexibility, and comprehensive specimen source documentation.
Basic Identifiers
| Field | V2 | V3 | Change |
|---|
| OBR-1 | Set ID: “1” (matches TQ1-1) | Set ID: “1” (matches TQ1-1) | Unchanged |
| OBR-2.1 | Placer Order Number (ZDnnnnnnnnn_nn) | Placer Order Number (10–20 alphanumeric) | Format relaxed |
| OBR-3.1 | Filler Order Number | Filler Order Number | Unchanged |
Universal Service Identifier (Test/Product Identification)
| Field | V2 | V3 | Change |
|---|
| OBR-4.1 | Code of diagnostic test | Code of test, test group, or healthcare product | Unified in V3 |
| OBR-4.2 | Name of diagnostic test | Name of test, test group, or healthcare product | Unified in V3 |
| OBR-4.3 | Coding: 99zda (ZD), 99zdl (user), or global code | Coding: L (local) or global code per table 0396 | Standardized to HL7 |
Key Change: V3 consolidates “diagnostic test,” “test group,” and “healthcare product” into a single structure and adopts HL7 standard coding markers.
Observation Dates
| Field | V2 | V3 | Change |
|---|
| OBR-7.1 | Observation start date/time (yyyyMMddHHmmss+HHmm) | Observation start date/time (empty if multiple specimens) | Semantically enhanced |
| OBR-8.1 | Observation end date/time (yyyyMMddHHmmss+HHmm) | Observation end date/time (empty if multiple specimens) | Semantically enhanced |
| Field | V2 | V3 | Change |
|---|
| OBR-10.1 | Collector’s healthcare provider ID or AGB-code | Collector’s healthcare provider ID or AGB-code | Unchanged |
| OBR-10.2.1 | Collector’s full surname | Collector’s full surname | Unchanged |
| OBR-10.3 | Collector’s initials | Collector’s initials | Unchanged |
| OBR-10.9.1 | Coding: 99zda or VEKTIS | Coding: L or VEKTIS | Standardized to HL7 |
| OBR-10.16.2 | (Not in V2) | Name of the collect location | New in V3 |
Impact: Addition of collect location name enables direct identification of sampling facility.
| Field | V2 | V3 | Change |
|---|
| OBR-11 | Specimen Action Code: “L” (home) or “O” (other) | Specimen Action Code: “L” (home) or “O” (other) | Unchanged |
| OBR-13 | Relevant Clinical Information (problem groups) | Relevant Clinical Information (problem groups) | Unchanged |
New in V3: Specimen Source Details (OBR-15)
The entirely new OBR-15 segment provides comprehensive specimen source documentation:
| Field | Description | Type | Coding |
|---|
| OBR-15.1.1 | Specimen source material code | Code | Local or HL7 standard |
| OBR-15.1.2 | Specimen source material name | Text | — |
| OBR-15.1.3 | Coding system: L (local), HL70487, or global | — | — |
| OBR-15.3 | Specimen collection method name | Text | — |
| OBR-15.4.1 | Specimen source site code | Code | Local or HL7 standard |
| OBR-15.4.2 | Specimen source site name | Text | — |
| OBR-15.4.3 | Coding system: L (local) or global | — | — |
| OBR-15.5.1 | Specimen source site modifier code | Code | Local or HL7 standard |
| OBR-15.5.2 | Specimen source site modifier name | Text | — |
| OBR-15.5.3 | Coding system: L (local) or global | — | — |
Impact: V3 introduces comprehensive, standardized specimen source documentation, significantly improving traceability and audit capabilities.
Ordering Provider (Responsible Referrer)
| Field | V2 | V3 | Change |
|---|
| OBR-16.1 | Referrer’s AGB-code | Referrer’s AGB-code | Unchanged |
| OBR-16.2.1 | Referrer’s full surname | Referrer’s full surname | Unchanged |
| OBR-16.3 | Referrer’s initials | Referrer’s initials | Unchanged |
| OBR-16.9.1 | Coding system: “VEKTIS” | Coding system: “VEKTIS” | Unchanged |
Call Back Phone Number & Fax
| Field | V2 | V3 | Change |
|---|
| OBR-17.1 | Phone number for results | Phone number for results | Unchanged |
| OBR-17.2 | Discriminator: “WPN” | Discriminator: “WPN” | Unchanged |
| OBR-17.3 | Discriminator: “PH” (phone) or “FX” (fax) | Discriminator: “PH” (phone) or “FX” (fax) | Unchanged |
| Field | V2 | V3 | Change |
|---|
| OBR-28.1 | Recipient’s AGB-code | Recipient’s AGB-code | Unchanged |
| OBR-28.2.1 | Recipient’s full surname | Recipient’s full surname | Unchanged |
| OBR-28.3 | (Not in V2) | Recipient’s initials (reserved for future use) | New in V3 |
| OBR-28.9.1 | Coding system: “VEKTIS” | Coding system: “VEKTIS” | Unchanged |
| OBR-28.16.2 | (Not in V2) | Organization name of recipient (reserved for future use) | New in V3 |
| OBR-28.21 | (Not in V2) | Specialism of recipient (reserved for future use) | New in V3 |
Impact: V3 reserves fields for future recipient organization and specialism tracking, improving routing flexibility.
| Field | V2 | V3 | Change |
|---|
| OBR-39.2 | Collector’s comment text | Collector’s comment text | Unchanged |
NTE is entirely new in V3, introducing three distinct comment patterns for cluster identification, file attachments, and research methodology.
NTE Option 1: ZorgDomein Cluster Name
| Field | Description |
|---|
| NTE-1 | Set ID: “1” |
| NTE-2 | Source of Comment: “P” (practitioner) |
| NTE-3 | Comment: Name of the ZorgDomein cluster to which the message was sent |
| NTE-4.1 | Comment Type: “ZD_CLUSTER_NAME” |
| NTE-4.2 | Comment Type Label: “ZorgDomein clusternaam” |
| NTE-4.3 | Coding system: “L” (local) |
Placement: Appears once immediately after MSH
Impact: Enables explicit tracking of target ZorgDomein cluster for message routing and audit purposes.
NTE Option 2: Attached Files Summary
| Field | Description |
|---|
| NTE-1 | Set ID: “1” (counts separately from Option 1) |
| NTE-2 | Source of Comment: “P” (practitioner) |
| NTE-3 | Comment: Summary of attached files (name, extension, size) |
| NTE-4.1 | Comment Type: “ATTACHMENTS” |
| NTE-4.2 | Comment Type Label: “Toegevoegde bijlagen” |
| NTE-4.3 | Coding system: “L” (local) |
Placement: Appears once when attachments exist
Impact: Provides metadata summary of attached files for quick reference.
NTE Option 3: Research Method (OBR-level)
| Field | Description |
|---|
| NTE-1 | Set ID: sequential under OBR |
| NTE-2 | Source of Comment: “P” (practitioner) |
| NTE-3 | Comment: Name of research method |
| NTE-4.1 | Comment Type: “RESEARCH_METHOD” |
| NTE-4.2 | Comment Type Label: “Onderzoeksmethode” |
| NTE-4.3 | Coding system: “L” (local) |
Placement: Nested under OBR segment
Impact: Enables detailed documentation of specialized research methodologies used.
OBX Segment: Observation/Result
OBX handles both structured observations and a new “requested tests” pattern for listing included test orders.
Existing OBX Observation Pattern
| Field | V2 | V3 | Change |
|---|
| OBX-1 | Set ID (sequential within ORC/OBR/OBX) | Set ID (sequential within ORC/OBR/OBX) | Unchanged |
| OBX-2 | Value Type: “ST”, “FT”, “DT”, “ED”, “CE” | Value Type: “ST”, “FT”, “DT”, “ED”, “CE” | Unchanged |
| OBX-3.1 | Observation Identifier (question code) | Observation Identifier (question code) | Unchanged |
| OBX-3.2 | Label of question | Label of question | Unchanged |
| OBX-3.3 | Coding: 99zda (ZD), 99zdl (user), or global | Coding: L (local) or global per table 0396 | Standardized to HL7 |
| OBX-5.1 | Observation Value (answer code) | Observation Value (answer code) | Unchanged |
| OBX-5.2 | Observation Value (answer text/value) | Observation Value (answer text/value) | Unchanged |
| OBX-5.3 | Coding: 99zda (ZD), 99zdl (user), or global | Coding: L (local) or global per table 0396 | Standardized to HL7 |
| OBX-6.1 | Units of value | Units of value | Unchanged |
| OBX-7 | References Range | References Range | Unchanged |
| OBX-11 | Observation Result Status: “F” | Observation Result Status: “F” | Unchanged |
Key Change: Coding system values changed from 99zda/99zdl to L for local codes, aligned with HL7 standards.
New in V3: Requested Tests OBX Pattern
V3 introduces a specialized OBX pattern (separate sequence) to enumerate requested tests:
| Field | Description | Value |
|---|
| OBX-1 | Set ID | 1, 2, … (for each test) |
| OBX-2 | Value Type | “CE” (coded entry) |
| OBX-3.1 | Observation Identifier | “REQUESTED_TESTS” |
| OBX-3.2 | Observation Identifier Text | “Aangevraagde onderzoeken” |
| OBX-3.3 | Coding system | “L” (local) |
| OBX-4 | Sequence Number | Incrementing sequence |
| OBX-5.1 | Observation Value (Code) | Code of each requested test |
| OBX-5.2 | Observation Value (Text) | Name/Text of each requested test |
| OBX-5.3 | Coding system | “L” (local) for each test |
| OBX-11 | Observation Result Status | “O” (order/in progress) |
Impact: Enables explicit listing of all requested tests in a structured, repeatable format.
Multiple-Choice Handling Changes
| Aspect | V2 | V3 | Change |
|---|
| Multiple Answers | Repeat OBX-5 values within single OBX | Increment full OBX-1 for each choice | V3 uses separate OBX records for multiple answers |
SPM Segment: Specimen
SPM is enhanced in V3 with expanded specimen type coding, collection method documentation, and container information.
Basic Identifiers
| Field | V2 | V3 | Change |
|---|
| SPM-1 | Set ID (sequential within ORC/OBR/SPM) | Set ID (sequential within ORC/OBR/SPM) | Unchanged |
| SPM-2.1.1 | (Not documented in V2) | Specimen ID (barcode of container) | New in V3 |
Specimen Type
| Field | V2 | V3 | Change |
|---|
| SPM-4.1 | Code of specimen source | Code of specimen source material | Unchanged semantics |
| SPM-4.2 | Name of specimen source | Name of specimen source material | Unchanged |
| SPM-4.3 | Coding: 99zda (ZD), 99zdl (user), or global | Coding: L (local), HL70487 (HL7), or global | Standardized to HL7 |
New in V3: Collection Method (SPM-7)
| Field | Description |
|---|
| SPM-7.1 | Specimen collection method code |
| SPM-7.2 | Name of specimen collection method |
| SPM-7.3 | Coding: L (local), HL70488 (HL7), or global |
New in V3: Specimen Source Site (SPM-8)
| Field | Description |
|---|
| SPM-8.1 | Code of specimen source site |
| SPM-8.2 | Name of specimen source site |
| SPM-8.3 | Coding: L (local) or global |
New in V3: Specimen Source Site Modifier (SPM-9)
| Field | Description |
|---|
| SPM-9.1 | Code of specimen source site modifier |
| SPM-9.2 | Name of specimen source site modifier |
| SPM-9.3 | Coding: L (local) or global |
Collection Dates
| Field | V2 | V3 | Change |
|---|
| SPM-17.1 | Specimen collection start date/time | Specimen collection start date/time | Renumbered |
| SPM-17.2 | Specimen collection end date/time | (Not separately specified) | Removed in V3 |
Note: V3 does not include a separate “collection end” timestamp; V3 uses 17.1.1 for start time and does not separately capture end time for multi-specimen scenarios.
New in V3: Grouped Specimen Count & Availability
| Field | Description |
|---|
| SPM-13 | Grouped Specimen Count (number of collected specimens) |
| SPM-20 | Specimen Availability: “Y” (collected) or “N” (not collected) |
| Field | Description |
|---|
| SPM-27.1 | Container type code |
| SPM-27.2 | Container type name |
| SPM-27.3 | Coding system: “L” (local) |
Impact: V3 provides comprehensive specimen documentation, including collection method, anatomical details, and container specifications for full audit trail support.
SAC Segment: Specimen Container
The SAC segment is simplified in V3 with container identification moved to the SPM segment.
| Field | V2 | V3 | Change |
|---|
| SAC-3.1 (Code) | Container Identifier (code) | (Moved to SPM-27.1) | Relocated in V3 |
| SAC-3.1 (Name) | Container Identifier (name) | (Moved to SPM-27.2) | Relocated in V3 |
Impact: V3 consolidates container information under SPM for a more unified specimen documentation structure.
Migration Checklist
When upgrading from OML v2 to v3:
| Item | Action | Impact |
|---|
| Order Numbering | Review OBR-2.1 and ORC-2.1 format compliance; update if using rigid ZDnnnnnnnnn_nn pattern | Medium – Format is more flexible |
| Coding Systems | Replace 99zda/99zdl with L for local codes and HL7 table references throughout | High – All receiving systems must support HL7 standard codes |
| Priority Values | Update TQ1-9.1 from “S”/“R” to HL7 table 0485 codes | Medium – Systems must support new code set |
| Specimen Source | Populate new OBR-15 fields for comprehensive source documentation | Medium – New fields optional but recommended |
| Specimen Details | Add SPM-7, 8, 9 for collection method and anatomical details | Medium – Enhances traceability |
| Contact Information | Add PID-13 email and ORC-22/23 facility address if available | Low – New optional fields |
| NTE Documentation | Implement NTE segments for cluster, attachments, and research method | Low – New optional segments |
| Testing | Validate all receiving system compatibility with V3 coding and new fields | Critical – Comprehensive testing required |
| Documentation | Update interface specifications, validation rules, and system documentation | Critical – Team awareness essential |
Backward Compatibility Notes
- Minimal Breaking Changes: Most V2 fields retain their semantics in V3
- Coding System Changes: Receiving systems MUST support both V2 values (
99zda/99zdl) and V3 values (L, HL7xxxx) during transition - New Optional Fields: Existing V2 implementations can ignore new V3 fields initially
- Field Renumbering: ORC-13 and SPM-17 renumbering requires attention during mapping
- Format Relaxation: V3 allows more flexible placer order numbers; be aware of length constraints
Technical Glossary
- ZorgDomein: Dutch healthcare domain/cluster identifier
- AGB-code: Dutch healthcare provider registration number
- VEKTIS: Dutch healthcare sector coding organization reference
- UZOVI: Dutch health insurer identification number
- Alphanumeric: Letters (A-Z, a-z) and digits (0-9) allowed
- HL7 Table 0485: Standard HL7 priority codes (e.g., A, E, R, S, T, U)
- HL7 Table 0487: Standard HL7 specimen source codes
- HL7 Table 0488: Standard HL7 specimen collection method codes
- Coding System “L”: HL7 v2.x standard for local/proprietary codes