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
Sub-order Results Delivery [LAB-36]
Draft. This implementation guide is a draft for discussion. It is not an
authoritative source and is not endorsed by NHS England, IHE or HL7. Check the cited
sources before using it for implementation.
Sub-order Results Delivery [LAB-36] - the Subcontractor returns the results of a
sub-order to the Requester, which then includes them in its own results to the Order
Result Tracker (LAB-3). See Inter-Laboratory Workflow (ILW).
References
In England laboratory to laboratory requests and results often go through
NPEx, the National Pathology Exchange - now marketed as Labgnostic, provided by
X-Lab Ltd and hosted with The Health Informatics Service (THIS) as a national NHS service since
2010. Each LIMS connects once to the exchange (rather than to every other laboratory), and
the exchange carries the sub-order ([LAB-35](LAB-35.html)) and its results
([LAB-36](LAB-36.html)). The identifiers, codes and content rules on these pages still apply
to what each LIMS sends to and receives from the exchange. Message formats and onboarding are
agreed with the provider (To confirm which HL7 v2 messages and versions NPEx uses).
Interaction
sequenceDiagram
participant SC as Subcontractor<br/>reference LIMS
participant RQ as Requester<br/>referring LIMS
SC ->> RQ: ORU^R01 / FHIR Laboratory Result (R01)
RQ -->> SC: ACK^R01 / FHIR response
HL7 v2.5.1 Message
ORU^R01, with the same structure as LAB-3. In
addition:
- OBR-2 is the Requester's sub-order number and OBR-3 the Subcontractor's laboratory
number
- OBR-29 Parent SHOULD repeat the original order (from LAB-35 ORC-8)
- OBX-23 / OBX-24 / OBX-25 SHALL identify the Subcontractor as the performing
laboratory, and SHALL be kept by the Requester when it reports the result onward
in LAB-3 (FHIR:
Observation.performer stays the Subcontractor; the Requester is the
DiagnosticReport.performer of its own report)
FHIR Message
The same Laboratory Result (R01) message as LAB-3.