ORM (V3)

Introduction

This document describes the technical specifications of the ZorgDomein HL7 V2.5.1 ORM V3 message. This message is used for sending diagnostic requests.

ZorgDomein adheres to the message structure and the required fields as specified in the international HL7 V2.5.1 specifications.

In this document, the term ‘acting referrer’ describes the person that used ZorgDomein and actually referred the patient. The term ‘responsible referrer’ describes the person that is responsible for that referral. The two often relate to the same person.

If the ZorgDomein content consists of a value between two double quotes, that value is the fixed value of that specific element.

Message structure

The ORM message has the following structure: 

• Message header
  • MSH - Message header
  • [NTE] - Name of the ZorgDomein cluster to which this message was sent
  • [NTE] - List with added attachments
• Patient details
  • PID - Patient Identification
  • PV1 - Inpatient details, if applicable
  • PV2 - Healthcare product details
  • [IN1] - Insurance details
• Healthcare product details
  • ORC - Logistic request details
  • OBR - Healthcare product details
  • [{OBX}] - Question and answer(s) for the requested healthcare product and all selected tests/examinanations
• Test group details (optional, repeatable, only applies to lab requests)
  • ORC - Logistic details
  • OBR - Requested test group details
  • [{OBX}] - Details of selected test
• Test/examination details (repeatable)
  • ORC - Logistic request details
  • OBR - Details of requested test/examination
  • [{NTE}] - Notes for selected test/examination (currently only contains the name of the research method for the selected test)
  • [{OBX}] - Question and answer(s) for the requested test/examination

NB: square brackets [] indicate an optional segment, curly brackets {} indicate a repeatable segment. 

Segment specifications

MSH - Message Header

Elem.nr.	Field name	ZorgDomein content
1	Field Separator	“|”.
2	Encoding Characters	“^~\&”.
3.1	Sending Application	“ZorgDomein”.
5.1	Receiving Application	Name of the receiving application.
6.1	Receiving Facility	Name of the receiving facility.
7.1	Date/Time Of Message	Date/time of message creation. Format: yyyyMMddHHmmss+HHmm.
9.1	Message Type	“ORM”.
9.2		“O01”.
9.3		“ORM_O01”.
10	Message Control ID	Unique message identifier.
11.1	Processing ID	“P”.
12.1	Version ID	“2.5.1”.
17	Country Code	“NLD”.
18	Character Set	“8859/1”.

NTE - Notes and Comments (sub MSH)

Elem.nr.	Field name	ZorgDomein content
NTE option 1: Name of the ZorgDomein cluster to which the message has been sent
1	Set ID - NTE	Sequence number unique for the NTE segment. Initial value: “1”.
2	Source of Comment	"P"
3	Comment	Name of the ZorgDomein cluster to which this message was sent.
4.1	Comment Type	"ZD_CLUSTER_NAME"
4.2		"ZorgDomein clusternaam"
4.3		"L"
NTE option 1: Summary of attached files
1	Set ID - NTE	Sequence number unique for the NTE segment. Initial value: “1”.
2	Source of Comment	"P"
3	Comment	Summary of attached files (file name, extension and size)
4.1	Comment Type	"ATTACHMENTS"
4.2		"Toegevoegde bijlagen"
4.3		"L"

PID - Patient Identification

Elem.nr.	Field name	ZorgDomein content
1	Set ID - PID	“1”.
PID-3, option 1: Patient’s BSN.
3.1	Patient Identifier List	The patient’s BSN.
3.4.1		“NLMINBIZA”.
3.5		“NNNLD”.
PID-3, option 2: XIS patient ID. The option “XIS patient ID” supplies all available patient IDs by repeating this field.
3.1	Patient Identifier List	XIS patient ID.
3.4.1		The AGB-code of the facility.
3.5		“PI”.
PID-3, option 3: ZorgDomein number
3.1	Patient Identifier List	ZorgDomein number. Format: ZDnnnnnnnnn, where each n denotes a digit.
3.4.1		“ZorgDomein”.
3.5		“VN”.
5.1.1	Patient Name	The patient’s full surname.
5.1.2		Prefix of surname in PID-5.1.3.
5.1.3		The patient’s own surname (without prefix).
5.1.4		Prefix of surname in PID-5.1.5.
5.1.5		The patient’s spouse surname (without prefix).
5.2		The patient’s first initial.
5.3		The patient’s second and further initials, separated by spaces.
5.7		“L”.
7.1	Date/Time ofBirth	The patient’s date of birth. Format: yyyyMMdd.
8	Administrative Sex	If the patient’s sex is male: “M”. If the patient’s sex is female: “F”. If the patient’s sex is not specified: “O”. If the patient’s sex is unknown: “U”.
11.1.1	Patient Address	Combination of PID-11.1.2, PID-11.1.3, and PID-11.2.
11.1.2		The patient’s street name.
11.1.3		The patient’s dwelling number.
11.2		The patient’s other designation.
11.3		The patient’s city name.
11.5		The patient’s postal code.
11.6		The patient’s country code.
11.7		If the specified patient address is the mailing address: “M”. If the specified patient address is the home address: “C” (this option is especially relevant for orders where home sampling is required, and the home address differs from the mailing address).
Note: PID-11 can have multiple values. The first value will always be the mailing address.
PID-13, option 1: Patient’s phone number
13.1	Phone Number - Home	The patient’s phone number.
13.2		“PRN”.
13.3		“PH”.
PID-13, option 2: Patient’s mobile phone number
13.1	Phone Number - Home	The patient’s mobile phone number.
13.2		“ORN”.
13.3		“CP”.
31	Identity Unknown Indicator	If the referrer’s verification of the BSN is unknown: “Y”. Else: “N”.
32	Identity Reliability Code	“NNNLD”.

PV1 - Patient Visit

Elem.nr.	Field name	ZorgDomein content
1	Set ID - PV1	“1”.
2	Patient Class	“O”.
3.1	Assigned Patient Location	(Reserved for future use) Name of the department where the patient is located
3.2		(Reserved for future use) Number of the room where the patient is located
3.6		(Reserved for future use) “D”
3.9		(Reserved for future use) Full description of the patient location, including the name of the healthcare organization, department and/or room number.
51	Visit Indicator	“V”.

PV2 - Patient Visit - Additional Information

Elem.nr.	Field name	ZorgDomein content
3.1	Admit Reason	Code of health care product.
3.2		Name of health care product.
3.3		“L”.

IN1 - Insurance

Elem.nr.	Field name	ZorgDomein content
1	Set ID - IN1	“1”.
2.2	Insurance Plan ID	“null”.
3.1	Insurance Company ID	If UZOVI number is present: UZOVI number. Else: “0”.
3.4.1		If UZOVI number is present: “VEKTIS”. Else: “LOCAL”.
3.5		If UZOVI number is present: “UZOVI”.
4.1	Insurance Company Name	The patient’s insurance company name.
36	Policy Number	The patient’s policy number.

ORC - Common Order

Elem.nr.	Field name	ZorgDomein content
1	Order Control	In case of a new order: “NW”. In case of a cancelled order: “CA” (reserved for future use). In case of a changed order: “XO” (reserved for future use).
2.1	Placer Order Number	ZorgDomein order number. Format: 10-20 alphanumeric characters
3.1	Filler Order Number	Order number of the receiving facility.
4.1	Placer Group Number	ZorgDomein number, optionally appended with cluster suffix. If a request is split up into multiple sub requests using separate messages, each sub request will have a unique group identifier, consisting of a ZD-number plus a cluster suffix. This identifier matches the bar code on patient messages.
7.4.1	Quantity/Timing	Requested date for sampling. Format: yyyyMMddHHmmss+HHmm.
7.6	Quantity/Timing - Priority	Priority code conform table 0485 of the international HL7 V2.5.1 specifications.
9.1	Date/Time of Transaction	Date/time of diagnostic request initiation. Format: yyyyMMddHHmmss+HHmm.
10.1	Entered By	The acting referrer’s AGB-code.
10.2.1		The acting referrer’s full surname.
10.3		The acting referrer’s initials.
10.9.1		If ORC-10.1 contains a value: “VEKTIS”.
12.1	Ordering Provider	The responsible referrer’s AGB-code.
12.2.1		The responsible referrer’s full surname.
12.3		The responsible referrer’s initials.
12.9.1		“VEKTIS”.
13.9	Enterer’s Location	Name of the acting referrer’s location.
13.10.1		AGB-code of the acting referrer’s location.
13.10.2		"VEKTIS"
ORC-14, option 1: Phone number for results
14.1	Call Back Phone Number	Phone number for results.
14.2		“WPN”.
14.3		“PH”.
ORC-14 option 2: Fax number for results
14.1	Call Back Phone Number	Fax number for results.
14.2		“WPN”.
14.3		“FX”.
15	Order Effective Date/Time	If ORC-1 contains the value “CA” or “XO”: Updated date/time of diagnostic request. Format: yyyyMMddHHmmss+HHmm.
17.1	Entering Organization	The AGB-code of the acting referrer’s organization.
17.2		The name of the acting referrer’s organization.
17.3		“VEKTIS”.
19.1	Action By	The responsible updater’s AGB-code.
19.2.1		The responsible updater’s full surname.
19.3		The responsible updater’s initials.
19.9.1		If ORC-19.1 contains a value: “VEKTIS”.
21.1	Ordering Facility Name	The name of the responsible referrer’s organization.
21.3		The AGB-code of the responsible referrer’s organization.
21.6.1		“VEKTIS”.
22.1.1	Ordering Facility Address	Combination of 22.1.2, 22.1.3, 22.2
22.1.2		The street name of the placer’s location.
22.1.3		The dwelling number of the placer’s location.
22.2		The other designation of the placer’s location.
22.3		The city name of the placer’s location.
22.5		The postal code of the placer’s location.
22.6		The country code of the placer’s location.
ORC-23, option 1: Phone number of the placer’s location.
23.1	Ordering Facility Phone Number	Phone number of the placer’s location.
23.2		"WPN"
23.3		"PH"
ORC-23, option 2: Fax number of the placer’s location.
23.1	Ordering Facility Phone Number	Fax number of the placer’s location.
23.2		"WPN"
23.3		"FX"

OBR - Observation Request

Elem.nr.	Field name	ZorgDomein content
1	Set ID - OBR	Sequence number unique within message for OBR segment. Initial value: “1”.
2.1	Placer Order Number	ZorgDomein order number. Format: 10-20 alphanumeric characters
3.1	Filler Order Number	Order number of the receiving facility.
4.1	Universal Service Identifier	If the OBR segment represents a diagnostic test: code of diagnostic test. If the OBR segment represents a diagnostic test group: code of diagnostic test group. If the OBR segment represents a healthcare product: code of healthcare product.
4.2		If the OBR segment represents a diagnostic test: name of diagnostic test. If the OBR segment represents a diagnostic test group: name of diagnostic test group. If the OBR segment represents a healthcare product: name of healthcare product.
4.3		If OBR-4.1 contains a local code: “L”. Else: Global standard code (see table 0396 of the international HL7 V2.5.1 specifications).
7.1	Observation Date/Time	Date/time the observation/collection was initiated. Format: yyyyMMddHHmmss+HHmm. NB: This field will remain empty if multiple specimen have been collected.
10.1	Collector Identifier	The collect employee’s ZorgDomein health care provider ID or AGB-code.
10.2.1		The collect employee’s full surname.
10.3		The collect employee’s initials.
10.9.1		If OBR-10.1 contains a value: “L” or “VEKTIS”.
10.16.2		Name of the collect location.
11	Specimen Action Code	If home sampling is requested: “L”. Else: “O”.
13	Relevant Clinical Information	Names of problem groups that include the diagnostic test, as selected by the acting referrer.
15.1.1	Specimen Source - Name or Code	Code of specimen source material.
15.1.2		Name of specimen source material.
15.1.3		If OBR-15.1.1 contains a local code: “L”. Else if OBR-15.1.1 contains a HL7 standard code: “HL70487”. Else: Global standard code (see table 0396 of the international HL7 V2.5.1 specifications).
NB: OBR-15 will remain empty if multiple specimen have been collected.
15.3	Specimen Source - Collection Method	Name of the specimen collection method
NB: OBR-15 will remain empty if multiple specimen have been collected.
15.4.1	Specimen Source - Body Site	Code of specimen source site.
15.4.2		Name of specimen source site.
15.4.3		If OBR-15.4.1 contains a local code: “L”. Else: Global standard code (see table 0396 of the international HL7 V2.5.1 specifications).
NB: OBR-15 will remain empty if multiple specimen have been collected.
15.5.1	Specimen Source - Site Modifier	Code of specimen source site modifier.
15.5.2		Name of specimen source site modifier.
15.5.3		If OBR-15.5.1 contains a local code: “L”. Else: Global standard code (see table 0396 of the international HL7 V2.5.1 specifications).
NB: OBR-15 will remain empty if multiple specimen have been collected.
16.1	Ordering Provider	The responsible referrer’s AGB-code.
16.2.1		The responsible referrer’s full surname.
16.3		The responsible referrer’s initials.
16.9.1		“VEKTIS”.
OBR-17, option 1: Phone number for results
17.1	Order Callback Phone Number	Phone number for results.
17.2		“WPN”.
17.3		“PH”.
OBR-17, option 2: Fax number for results
17.1	Order Callback Phone Number	Fax number for results.
17.2		“WPN”.
17.3		“FX”.
27.4	Quantity/Timing	Requested date for sampling. Format: yyyyMMddHHmmss+HHmm.
28.1	Result Copies To	AGB-code of person to send copy to as entered by the acting referrer.
28.2.1		Full surname of person to send copy to as entered by the acting referrer.
28.3		(Reserved for future use) Initials of person to send copy to as entered by the acting referrer.
28.9.1		If OBR-28.1 contains a value: “VEKTIS”.
28.16.2		(Reserved for future use) Organization name to send copy to as entered by the acting referrer.
28.21		(Reserved for future use) Specialism of person to send copy to as entered by the acting referrer.
39.2	Collector’s Comment	The collect employee’s comment.

NTE - Notes and Comments (sub OBR)

Elem.nr.	Field name	ZorgDomein content
NTE option 1: Name of research method
1	Set ID - NTE	Sequence number unique within the combination of respective ORC, OBR and NTE segments. Initial value: “1”.
2	Source of Comment	"P"
3	Comment	Name of research method.
4.1	Comment Type	"RESEARCH_METHOD"
4.2		"Onderzoeksmethode"
4.3		"L"

OBX - Observation/Result

Elem.nr.	Field name	ZorgDomein content
1	Set ID - OBX	Sequence number unique within the combination of respective ORC, OBR, and OBX segments. Initial value: “1”.
2	Value Type	If OBX-5 contains string data: “ST”. If OBX-5 contains formatted text: “FT”. If OBX-5 contains a date: “DT”. If OBX-5 contains encapsulated data: “ED”. If OBX-5 contains coded entry: “CE”.
3.1	Observation Identifier	If the OBX segments represents a question that is relevant for the requested test(s): code of question. If the OBX segments represents a selected diagnostic test (for ORC-OBR combinations that represent a test group): "REQUESTED_TESTS". If the OBX segment provides the reason for cancellation of the request (for ORC-OBR combinations that represent the healthcare product): "CANCELLATION_REASON".
3.2		If the OBX segments represents a question that is relevant for the requested test(s): label of question. If the OBX segments represents a selected diagnostic test (for ORC-OBR combinations that represent a test group): "Aangevraagde onderzoeken". If the OBX segment provides the reason for cancellation of the request (for ORC-OBR combinations that represent the healthcare product): "Reden van annulering".
3.3		If OBX-3.1 contains a value: If OBX-3.1 contains a local code: “L”. Else: Global standard code (see table 0396 of the international HL7 V2.5.1 specifications).
4	Observation Sub-ID	If there are multiple OBX segments with the same value for OBX-3 under one ORC-OBR combination, the OBX segment must be interpreted a data element that is part of a multiple choice question, where each OBX segment provides one answer to that question. In that case OBX-4 provides a unique sequence number of the answer within the sequence of answers.
OBX-5, option 1: Coded Element (OBX-2 = CE)
5.1	Observation Value	If the OBX segments represents a question that is relevant for the requested test(s): code of answer/option to the question. If the OBX segments represents a selected diagnostic test (for ORC-OBR combinations that represent a test group): code of the diagnostic test. If the OBX segment provides the reason for cancellation of the request (for ORC-OBR combinations that represent the healthcare product): coded value of the reason for cancellation.
5.2		If the OBX segments represents a coded question that is relevant for the requested test(s): text of answer/option to the question. If the OBX segments represents a selected diagnostic test (for ORC-OBR combinations that represent a test group): name of the diagnostic test. If the OBX segment provides the reason for cancellation of the request (for ORC-OBR combinations that represent the healthcare product): text of the reason for cancellation.
5.3		"L".
OBX-5, option 2: other value types
5	Observation Value	Answer to a question that is relevant for the requested test(s).
6.1	Units	Unity of the value of answer/option to the question.
7	References Range	The range to which the answer/option to the question is restricted.
11	Observation Result Status	If the OBX segment represents a question that is relevant for the requested test(s): "F". If the OBX segment represents a selected diagnostic test (for ORC-OBR combinations that represent a test group) or if the OBX segment provides the reason for cancellation of the request (for ORC-OBR combinations that represent the healthcare product): "O".

Change log

Date	Comments
1-2-2024	Removed invalid specification for empty BSN in PID-3
10-17-2023	New format for placer order number (OCR-2.1 and OBR-2.1) and specification of OBX segment for reason of cancellation
6-3-2023	Specification marked as preferent message
4-6-2021	Publication draft specification

Sample messages

• ORM V3 imaging request example 
• ORM V3 cancellation of imaging request example