HL7 ORU Message – Everything You Need to Know in 2024

Posted in HL7

Ever thought about how healthcare providers easily share patient information, like lab test results, across different systems? The answer is a standardized messaging format: the HL7 ORU message! An HL7 Observation Result (ORU) message contains information about a patient’s medical observations.

Overview – HL7 ORU Message

Healthcare information exchange is the foundation of improving patient care, and timely transmission of patient data among healthcare providers is crucial for accurate decision-making. Since healthcare information is sensitive and vulnerable to hacking, organizations leverage HL7 messages to create a secure mechanism for swapping information.

Health Level 7 (HL7) messages are built on a set of international standards (HL7 standards) that provide a framework for transmitting clinical and administrative data among diverse medical applications. Clinicians, hospitals, and practices use HL7 messages to enable cogs of machines to speak to one another and work as consolidated sources of information.

Today, more than 90% of American institutes use HL7, which has become a global standard after being adopted in at least 27 countries. HL7 messages aim to provide convenience in the interchange of electronic medical data. Although there are many HL7 message examples, the ORU messages are an overriding information-sharing method. Let’s take a deeper look at some aspects of HL7 ORU messages, their structure, content, and significance in modern healthcare.

What is an HL7 ORU Message?

HL7 Observation Result (ORU) is an HL7 message used to share patient observational results, including clinical, lab, or other test reports, between different systems.

An HL7 ORU message contains information about a patient’s medical observation. It is a response generated for the order received from a clinical system. (The order message is called an HL7 Order Entry or ORM message.)

ORU message is designed to accommodate information sharing in laboratories, EKG studies, medical interpretations, and imaging studies. Moreover, it is also used to communicate order and results associated with clinical trials (for example, drug development).

All ORU messages consist of several segments that allow you to construct any clinical report as a multi-level hierarchy and form a complete message.

HL7 ORU Message Types

The HL7 ORU message has two different types: 

1. ORU^R01 HL7 Message

This message is an unsolicited transfer of information from one system (the result-producing system) to another system (the ordering system).

This transmission of observation results occurs without receiving an order from the other system. The message helps transmit the results from a producing system (e.g., EKG system, LIS) to a medical record archival system (e.g., HIS, EMR) to register for clinical trials or share medical reporting.

HL7 ORU R01 message accommodates reporting many types of observations, such as:

• Imaging study reports
• EKG pulmonary function study results
• Lab results
• Patient condition data or other health data (such as vital signs, allergies, symptoms, notes, etc.)

2. ORU^W01 HL7 Message

It is a waveform response or an unsolicited ORU message that transmits requested information (which means the system receives the order and then transfers the data.) This information is waveform data (generated from electrocardiograms) and is the outcome of an ordered series of observations or tests.

The Structure of an HL7 ORU Message

ORU message is a hierarchical structure linked with a trigger event. According to HL7, a trigger event is “an event in the real world of health care (that) creates the need for data to flow among systems.”

Whenever a trigger event occurs (such as patient admission or discharge), it has an associated abstract message that explains the type of data providers need to share in response to the event.

An HL7 message has one or more segments, each displayed on a different line of text. A carriage return character (\r, which is 0D in hexadecimal) separates one segment from another.  Each segment comprises one or more composites or fields. A pipe, shown as (|), separates one composite from another. If it contains other composites, these sub-fields are normally separated by caret (^) characters.

The Contents of an HL7 ORU Message

HL7 ORU message does not natively contain any images. Instead, its format combines codes, texts, and numbers to communicate results.

ORU messages consist of segments, which refer to sections with specific chunks of information that combine to form the overall message.

In the HL7 ORU message, some segments are mandatory, while others are optional ( [ ] indicates optional segments and { } refers to repetition.)

MSH – Message Heading

This segment is crucial because it contains information about the receiver and sender and the date and time the message was generated.

PID – Patient Identification

The PID segment includes essential patient information, such as name, patient identifier, date of birth, and more. As this segment is patient-specific, it is a mandatory component of any HL7 message.

PV1 – Patient Visit

The PV1 section is essential and involves details about patient visits such as attending doctor, servicing facility, and visit ID.

OBR – Observation Request

It is a crucial segment that helps identify the observation received in OMR to generate an ORU message. The OBR (Observation Request) segment is a crucial link between order entry and result reporting, providing details like the order number, order status, etc. 

[{OBX}] – Observation Segment

This segment holds information about the observation result. An OBX communicates a single observation, like a lab test or vital sign. For multiple observations, this segment would repeat. 

[{CTI}] – Clinical Trial Identification

CTI is an optional segment and appears if the results link to a clinical trial. It includes information such as the trial ID, the time point, and the study phase. CTIs can occur once or repeat in the same message if there are multiple clinical trial identifications.

Components
of HL7 ORU Message

How to Create an HL7 ORU Message?

ORU vs ORM has a template available; however, you can create your own message too. Here’s how you can create an HL7 ORU message with the help of a standard format: 

• From the Profile button (on the HL7 interface), click Generate message
• Choose ‘HL7 v2. 6 conformance’ from the profile library. Using this profile will generate the ‘HL7 v2. 6 message’.
• Then, select the ‘ADT-A01’ trigger event. This will create ADT (Admit, Discharge, Transfer) messages.
• Click ‘OK’

How to Send an HL7 ORU Message?

HL7 messages use a variety of TCP/IP protocols for transfer. These include:

• File Transfer Protocol (FTP)
• Lower Layer Protocol (LLP)
• Simple Object Access Protocol (SOAP)
• Simple Mail Transfer Protocol (SMTP)

TCP/IP data transmission happens in the form of a stream of bites. So, if there are multiple HL7 messages, you will need to send them as a continuous stream. Although there are many protocols for point-to-point interfaces, the most commonly used method is LLP. But, if you have a batch of HL7 processing, you can utilize FTP.

Smoothly Exchange Patient Data By Utilizing HL7 Integration With Folio3 Digital Health 

Healthcare facilities are moving towards digitizing patient data with tailored EMR solutions. This shift increases the need to transmit data safely, on time, and legibly across multiple systems. Our HL7 integration service can help you improve workflow efficiency and help with informed decision-making, improving patient care. Connect with Folio3 Digital Health and our team of developers and designers to help you with your query. Every Folio3 Digital Health product is HIPAA-compliant and uses the latest HL7 and FHIR interoperability standards to abide by the compliance rules. 

Conclusion

Connecting disparate systems to exchange information has always been challenging in healthcare organizations. While interoperability has stepped up to create a seamless connection, challenges and limitations continue to exist. With the introduction of HL7 standards for data exchange and defining the format of different message types like ORU or ORM, healthcare can bridge the gap between multiple settings and seamlessly connect disparate systems to share information.

HL7 ORU and OMR messages play a significant role in this regard. They help connect heterogeneous systems to send orders and transfer electronic health data feasibly and securely. As healthcare continues to shift data trends in the future, HL7 messages supported by constant improvements and evolution will be able to maintain their relevance and upgrade to new roles to support new use cases in the long run.

Frequently Asked Questions

What is an ORU HL7 Message?

An ORU message is a structured report that contains results of the clinical, lab, and other medical data related to a patient. It facilitates transferring patient information among healthcare providers- switching data from data-producing systems to record management systems.

Describe the Different Fields in an HL7 ORU Message

A single ORU HL7 message is a collection of segments that create the whole message. Entering data in some of these fields is optional, while others are mandatory and must be filled.

Here’s a quick view of what these fields are:

•     Message Heading – contains sender and receiver’s information and details about the type of message and time and date when it was sent.
•     Patient Identification – relates the message to a patient and adds patient data.
•     Patient Visit – includes patient visit details
•     Observation Results – it identifies the request order to produce the ORU message
•     Observation Segment – this segment contains the result of the tests or series of observation

Discuss Common Problems with HL7 ORU Messages

In comparison to older methods of data sharing, HL7 protocols and messages are easier and more efficient at bridging the gap between healthcare systems and facilitating the exchange of data. Although they have many advantages, they also introduce new challenges, such as:

1. Different Interpretations

Every system interprets data differently, and context and workflows influence semantics. Some systems may use the visit number and others the account number to consider a patient compliant with clinical workflows. Such differences in semantics impact how a system receives and deals with information.

2. Optional vs. Required

Because one chunk of information can be used in multiple contexts to achieve different goals, some fields in the message are optional. However, some healthcare products relax or add new data constraint rules to make them mandatory. Therefore, the data shared in messages needs a case-by-case analysis to identify if it’s required or supplementary.

3. Customizations in Segments and Fields

Field size, data types, and segments are customizable. You need to map the information on a data structure you are acquainted with in order to avoid losing data.

What is HL7 in healthcare?

HL7 (or Health Level 7) is a set of international protocols that ensure the correct and logical transfer of medical data between different systems. These protocols allow hospitals to communicate and share information whenever they need it.

For the healthcare domain, HL7 provides several versions of application layer protocols. The most common is the 2. x family, and the newest is the HL7 FHIR generation standards framework. FHIR combines the features of Version 2 and Version 3 and has shown immense improvements over these existing standards.

Because of similar capabilities, there is confusion surrounding the difference between HL7 and FHIR. While HL7 is the foundation of these protocols, FHIR builds on it but is a far better and more advanced interoperability standard. FHIR facilitates medical device integration and brings a new level of interoperability to rapidly exchange the growing amount of health data.

What are HL7 message types ADT ORM ORU?

ADT

ADT stands for Admit, Discharge, and Transfer, and it typically springs from an EHR or registration system. These messages help keep ancillary systems in sync regarding a patient’s state. As soon as a provider updates a patient’s record, the ADT message is sent.

ORM

HL7 ORM vs ORU message is an order a clinical system generates to request information or services from another clinical system (such as a laboratory data management system.)

ORU

HL7 Observation Result (ORU) is a response to the ORM message. It holds information about a patient’s clinical observations. This message helps transfer the information to the sources that requested the information.

What is HL7 ORM Message?

In order and result-based workflows, the HL7 order message (ORM) requests a facility or a provider to share information. Although this ordering method is more common for patient-specific orders, it is also useful for non-patient information requests.

The HL7 ORM message structure is similar to the hierarchical structure of the ORU message. However, HL7 ORM message segments differ from ORU message segments because of their basic function differences. The former is the order, while the latter is the response to that order.

ORM vs. ORU Messages 

HL7 ORM vs ORU is simple. ORM messages are used to place orders for tests or procedures, while HL7 ORU messages are used to send results back to the ordering system.

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