England Pathology and Laboratory Medicine (PaLM) Technical Framework
0.1.0 - ci-build
England Pathology and Laboratory Medicine (PaLM) Technical Framework
0.1.0 - ci-build
England Pathology and Laboratory Medicine (PaLM) Technical Framework - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Placer Order Management [LAB-1] - the Order Placer (EPR, order comms, GP system) sends a new order to the Order Filler (LIMS), and may later cancel it. The Order Filler accepts or rejects it.
sequenceDiagram
participant OP as Order Placer<br/>EPR / GP system
participant OF as Order Filler<br/>LIMS
OP ->> OF: OML^O21 (ORC-1 NW new, CA cancel) / FHIR Laboratory Order (O21)
OF -->> OP: ORL^O22 (ORC-1 OK accepted, UA unable to accept, CR cancelled) / FHIR response
| Segment | Optionality | Notes | FHIR |
|---|---|---|---|
| MSH | 1..1 | MessageHeader | |
| PID | 1..1 | Patient | |
| PV1 | 0..1 | Requesting location (PV1-3) and clinician (PV1-8); PV1-19 visit number if known | ServiceRequest.encounter, requester |
| ORDER | 1..* | One per test or panel | |
| - ORC | 1..1 | Laboratory Order | |
| - TQ1 | 0..1 | Priority. No TQ1 means routine | ServiceRequest.priority |
| - OBSERVATION REQUEST | 1..1 | ||
| – OBR | 1..1 | Laboratory Order | |
| – NTE | 0..* | Clinical details (NTE-2 = P) |
ServiceRequest.note |
| – DG1 | 0..* | ServiceRequest.reasonCode |
|
| – OBSERVATION | 0..* | Ask at order entry answers (IHE LCSD) | ServiceRequest.supportingInfo → Observation or QuestionnaireResponse |
| — OBX | 1..1 | ||
| - SPECIMEN | 0..* | Specimen collected by the Order Placer | |
| – SPM | 1..1 | Specimen |
The FHIR equivalent is the Laboratory Order (O21)
message: a Bundle Message whose
MessageHeader has eventCoding v2-0003 O21
and focus the Laboratory Order(s). ORL^O22
is a FHIR response message (MessageHeader.response). Order control (ORC-1) maps to
ServiceRequest.status - see v2-0119-to-request-status.
A GP requests a full blood count.
MSH|^~\&|GPSYSTEM|A12345|LIMS|R0A|20261103091005||OML^O21^OML_O21|GP-MSG-000501|P|2.5.1|||AL
PID|1||633^^^R0A^MR~9449305552^^^NHS^NH||CHISLETT^Octavia^^^Miss||20080920|F|||1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST|||||||||||||||||||||01
PV1|1|O|^^^^^^^^Example Surgery^A12345|||||G1234567^GREEN^Alex^^^Dr^^^GMP^^^^DN
ORC|NW|GP-ORD-000123^GPSYSTEM||GP-REQ-000045^GPSYSTEM|||||20261103091000|||G1234567^GREEN^Alex^^^Dr^^^GMP^^^^DN|||||||||Example Surgery^^^^^^^^^A12345
TQ1|1||||||||R^Routine^HL70485
OBR|1|GP-ORD-000123^GPSYSTEM||1022441000000101^FBC - full blood count^SCT||||||||||||G1234567^GREEN^Alex^^^Dr^^^GMP^^^^DN|||||||||||||||^Tiredness
NTE|1|P|Tired all the time for 3 months. ? anaemia
SPM|1|GP-SPC-000123&GPSYSTEM||119297000^Blood specimen^SCT|||||||||||||20261103091500
FHIR equivalent: Bundle Message - Laboratory Order (O21), with the Laboratory Order and Patient.