Eff.

16-Mar-2020 Title:RALS Generic Unsolicited Outbound Interface Specif Document #:D10023841

The RALSTM System

Generic Unsolicited Outbound Interface

Overview
The RALSTM Outbound Interface is an HL7 interface used to send patient test results from supported
medical devices to Laboratory Information System (LIS) or Hospital Information System (HIS) or
Electronic Medical Record (EMR). This document describes the standard HL7 messaging format for an
unsolicited, unidirectional HL7 ORU message. Enhanced (bidirectional) messaging is available.

Interface Connection Lower Layer Protocol (LLP)

The RALSTM Outbound Interface uses the minimal lower layer protocol (LLP) over TCP/IP as described in
the HL7 version 2.4 specifications.
 The RALSTM Outbound Interface will act as the Client that initiates TCP/IP connections to the
designated IP Address and Port number on the LIS/HIS/EMR.
 The receiving system (LIS/HIS/EMR) will act as the Server that listens for connections on a
specific IP Address and Port number.

Result Messages Structure

Test results are sent using ORU messages based on the standard structure as defined in the HL7
Specification version 2.4. The basic ORU message structure is as follows:
MSH – Message Header Segment
PID – Patient Identification Segment
ORC – Common Record Control Segment
[{OBR}] – Observation Request Segments
[{NTE}] – Order Comment(s)
[{OBX}] – Observation/Result Segments
[{NTE}] – Observation Note(s)

MSH – Message Header Segment

NOTE: Fields in BOLD will always contain information.
R – Required, O – Optional, X – Ignored and not valued.

Field Description Option Value(s)

MSH.1 Field Separator R |
MSH.2 Encoding Characters R ^~\&
MSH.3 Sending Application R RALS
MSH.4 Sending Facility R RALS-LIS
MSH.5 Receiving Application R LAB
MSH.6 Receiving Facility R LAB
MSH.7 Date/Time of Message R Now - CCYYMMDDHHMMSS
MSH.8 Security X

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Eff.16-Mar-2020 Title:RALS Generic Unsolicited Outbound Interface Specif Document #:D10023841

The RALSTM System

Generic Unsolicited Outbound Interface

MSH.9.1 Message Type R ORU

MSH.9.2 Trigger Event R R01
MSH.10 Message Control ID R RALS Unique Result Identifier
MSH.11 Processing ID R P
MSH.12 Version ID R 2.4
MSH.13 Sequence Number X
MSH.14 Continuation pointer X
MSH.15 Accept acknowledgement R AL
type
MSH.16 Application R AL
acknowledgement type

PID - Patient Identification Segment

NOTE: Fields in BOLD are primary patient identifiers based on the Outbound Interface configuration.
Field Description Option Value(s)
PID.1 Set ID – PID R [incremental value starting at 1]
PID.2 Patient ID X
PID.3 Patient Identifier List R/O Patient ID 1 in configuration [typically Med Rec #]
PID.4 Alternate Patient ID R/O Patient ID 3 in configuration [typically Episode #]
PID.5.1 Patient Last Name O available with patient ID validation
PID.5.2 Patient First Name O available with patient ID validation
PID.5.3 Patient Middle O available with patient ID validation
PID.6 Mother’s Maiden Name X
PID.7 Date/Time of Birth O available with patient ID validation
PID.8 Sex O available with patient ID validation
PID.9 Patient Alias X
: : :
PID.17 Religion X
PID.18 Patient Account Number R/O Patient ID 2 in configuration [typically Account #]

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The RALSTM System

Generic Unsolicited Outbound Interface

ORC – ORDER RECORD CONTROL

NOTE: Fields in BOLD will always contain information.
Field Description Option Value(s)
ORC.1 Order Control R NW
ORC.2 Placer Order Number X
ORC.3 Filler Order Number R RALS Unique Result Identifier
ORC.4 Placer Group Number X
: : :
ORC.8 Parent X
ORC.9 Date/Time of Transaction R Test Date/Time - CCYYMMDDHHMMSS
ORC.10 Entered By R User ID from Instrument
ORC.11 Verified By X
ORC.12 Ordering Provider X
ORC.13 Enterer’s Location R Instrument’s Assigned Location in RALS
ORC.14 Call Back Phone Number X
: : :
ORC.16 Order Control Code Reason X
ORC.17 Entering Organization R Institution Name in RALS
ORC.18 Entering Device R Instrument ID^Type

OBR – Observation Request Segment

This table represents the general specification for the Results Interface
NOTE: Fields in BOLD will always contain information.
Field Description Option Value(s)
OBR.1 Set ID – OBR R [incremental value starting at 1]
OBR.2 Placer Order Number X
OBR.3 Filler Order Number R RALS Unique Result Identifier
OBR.4 Universal Service ID R Panel Code, as configured for a Panel
OBR.5 Priority X
OBR.6 Requested Date/Time X
OBR.7 Observation Date/Time R Test Date/Time - CCYYMMDDHHMMSS
OBR.8 Observation End Date/Time X
: : :
OBR.14 Specimen Received Date X
Specimen Source Name or
OBR.15.1 R/O Result Specimen Type, if available
Code
OBR.15.2 Additives X

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The RALSTM System

Generic Unsolicited Outbound Interface

OBR.15.3 Free text X

OBR.15.4 Body Site O Result Specimen Site, if available
OBR.16 Ordering Provider X
OBR.17 Order Callback Phone # X
: : :
OBR.21 Filler Field 2 X
Results Status Change – Now - CCYYMMDDHHMMSS
OBR.22 R
Date/Time
OBR.23 Charge to Practice X
OBR.24 Diagnostic Serv Sect ID X
OBR.25 Result Status R F
OBR.26 Parent Result X
: : :
OBR.33 Assistant Result Interpreter X
OBR.34 Technician R Operator ID entered at the device

NTE – Comment Segment

This table represents the general specification for the Results Interface. NTE segment(s) may be
available after OBR or OBX segments.
NOTE: Fields in BOLD will always contain information.
Field Description Option Value
NTE.1 Set ID - NTE R [incremental value starting at 1]
NTE.2 Source of Comment X
NTE.3 Comment R Comment description(s), based on configuration
NTE.4 Comment Type X

OBX – Observation/Result Segment

This table represents the general specification for the Results Interface.
NOTE: Fields in BOLD will always contain information.
Field Description Option Value(s)
OBX.1 Set ID – OBX R [incremental value starting at 1]
OBX.2 Value Type R ST – String Data
OBX.3 Observation Identifier R Result value LIS Name, as configured for panel
OBX.4 Observation Sub-ID X
OBX.5 Observation Value R Value associated with OBX.3
OBX.6 Units O Units as defined by the device
OBX.7 Reference Range O As defined by device or in RALS

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The RALSTM System

Generic Unsolicited Outbound Interface

Field Description Option Value(s)

OBX.8 Abnormal Flags O As defined by device or in RALS
OBX.9 Probability X
OBX.10 Nature of Abnormal Test X
OBX.11 Observation Result Status R F (final result)
OBX.12 Effective Date of Reference X
: Range :
OBX.15 : :
Producer’s ID X
OBX.16 Responsible Observer R Operator ID entered at the device

EXAMPLE Messages:
This example shows a sample HL7 message for an ID NOWTM test result using an Account Number as a
Patient Identifier:
MSH|^~\&|RALS|RALS-LIS|LAB|LAB|20140815084614||ORU^R01|20140815084615:01:9058@4|P|2.4|||AL|AL||||
PID||||||||||||||||||100||||||||||||
ORC|NW||90584||||||20130923153432|50|||Test Lab||||AI HQ|7F947715^Alere-i|
OBR|||90584|FLU|||20130923153432|||||||||||||||||||||||||||50|||||||||
OBX|1|ST|FLUB||POSITIVE||||||F|||||50|||
OBX|2|ST|FLUA||POSITIVE||||||F|||||50|||

This example shows a sample HL7 message for a Triage® Cardiac Panel using a Medical Record
Number as the Patient Identifier:
MSH|^~\&|RALS|RALS-
LIS|LAB|LAB|20140822162256||ORU^R01|20140822162256:01:1001@15|P|2.4|||AL|AL||||
PID|||18901|||||||||||||||||||||||||||
ORC|NW||100115||||||20140820084510|100|||Default Location||||Default Institution|2468^Triage|
OBR|||100115|CARDIAC|||20140820084510|||||||||||||||||||||||||||100|||||||||
NTE|||Doctor Notified|
OBX||ST|TNI||0.21|ng/mL|||||F|||||100|||
OBX||ST|MYO||>500|ng/mL|||||F|||||100|||
OBX||ST|CKMB||1.2|ng/mL|||||F|||||100|||

Commit/Accept Acknowledgement Messages

The receiving system will respond to Result Messages with a Commit Acknowledgement. The Commit
Acknowledgement message structure is as follows:
MSH – Message Header Segment
MSA – Message Acknowledgement Segment

Example Message:
MSH|^~\&|LAB|LAB|RALS|RALS-LIS|20140815092414||ACK|20140815092414||||||
MSA|CA|20140815092353:01:9058@1||||

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The RALSTM System

Generic Unsolicited Outbound Interface

NOTE Fields in BOLD will always contain information.

Field Description Option Value
MSH.1 Field Separator R |
MSH.2 Encoding Characters R ^~\&
MSH.3 Sending Application R RALS
MSH.4 Sending Facility R RALS-LIS
MSH.5 Receiving Application R LAB
MSH.6 Receiving Facility R LAB
MSH.7 Date/Time of Message R Now - CCYYMMDDHHMMSS
MSH.8 Security X
MSH.9 Message Type R ACK
MSH.10 Message Control ID R Unique LIS message control ID

MSA – Message Acknowledgement Segment

NOTE Fields in BOLD will always contain information.
Field Description Option Value
MSA.1 Acknowledgement Code R “CA”, “CE”, “AA”, “AE”
R Message Control ID (MSH.10) from the
MSA.2 Message Control ID
corresponding Results Message
MSA.3 Text Message X
MSA.4 Expected Seq Number X
MSA.5 Delayed Ack Type X
MSA.6 Error Condition X

Application (Enhanced) Acknowledgement

For those systems set to support Application Acknowledgements, a message is created similar to the
Commit Acknowledgment except that the Message Type is ORR^O02 rather than ACK and the ACK code
is AA, AE, or AR. If the ACK code is AA the Result will be marked as UPLOAD COMPLETED in the
RALS database, other it will be marked as UPLOAD FAILED with the reason for failure displayed.

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