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ORM (V3)

Important note:

This specification is a draft specification. Together with a few XIS vendors, we will run a pilot implementation of this specification at a small number of customers. As soon a these pilot implementations have proven to be successful, this specification will be released as the preferent HL7 ORM message. If you would like to participate in this pilot please contact us.

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. This option is always supplied in the message. When the BSN is not available, PID-3.1 is left blank.
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: “H” (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 number with sequence number.
Format: ZDnnnnnnnnn_nn, where each n denotes a digit. The underscore is followed by the sequence number, which is unique within the message, starting from 01.
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 number with sequence number.
Format: ZDnnnnnnnnn_nn, where each n denotes a digit. The underscore is followed by the sequence number, which is unique within the message, starting from 01.
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"
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"
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.
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
5.2 If the OBX segments represents a selected diagnostic test (for ORC-OBR combinations that represent a test group): code of the diagnostic test.
Else if the OBX segments represents a coded question that is relevant for the requested test(s): code of answer/option to the question.
Else: answer to a question that is relevant for the requestsed test(s).
5.3 If OBX-5.1 contains a value: "L".
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 segments represents a question that is relevant for the requested test(s): "F".
If the OBX segments represents a selected diagnostic test (for ORC-OBR combinations that represent a test group): "O".

Version history

Version Date Author Description
0.9 4-6-2021 Ruben Pape -

Sample messages