A "content pattern" indicates how PKB will interpret the contents of your message. This provides additional guidance over and above the syntactic requirements of individual segments.

PKB supports two different content patterns for OBR groups. When a (non-radiology) report is received, we will inspect each OBR group to determine which content pattern has been provided.

Single textual laboratory report

PKB uses the following criteria to determine if the OBR group contains a single textual laboratory report:

• There are 1 or more OBX segments, which together contain at least 2 lines of text

• Each OBX segment declares a textual data type (TX, FT, ST)

• All the OBX segments have matching test IDs (OBX-3.1 and OBX-3.3, case sensitive)

The test code information for a textual laboratory report is taken from the OBR segment (OBR-4).

The OBX segments are treated as lines within the report, and do not maintain their own identity. The contents of the OBR group will be kept together, and displayed as originally provided.

NTE segments will be treated as lines of the report, just like OBX segments; their contents will appear in the same location as provided.

Note: when sending a single textual laboratory report, some metadata fields will only be taken from the first OBX segment. Importantly, if you wish to apply a patient delay this must be provided in the first OBX segment.

Collection of individual test results and measurements

If an OBR group does not contain a single textual laboratory report, then it is assumed to contain a collection of individual test results, each of which is provided in its own OBX segment.

The test code information for an individual result is taken from the OBX segment (OBX-3). Test results are considered to be meaningful even outside the context of the report in which they were provided.

The comments for each test result will be the union of the comments (NTE segments) provided for the OBR group and the comments (NTE segments) provided for the test result specifically.

PKB processes content of this form in an OBX-centric manner. That is, PKB extracts the test results from the report and does not guarantee to display them alongside the other test results with which they were originally provided.

Sometimes, the same test result might be reported as part of more than one profile. This is valid, providing that each OBX segment appears no more than once in any given OBR group. However, since PKB does not include the profile as part of the result identity then all except the first instance of the OBX segment will be silently ignored. It is not valid to provide different results for the same test ID in different profiles within a given laboratory order.

[[Lab Report]]

Matched on: [[Lab Report.External ID]] as derived from ORC-3.1 or OBR-3.1

When matched: Associated [[Lab Result]] entries are individually matched. Note: if a [[Lab Result]] that was previously provided with the [[Lab Report]] is omitted from this [[Lab Report]], the [[Lab Result]] will be left unmodified. It will not be deleted.

Particular care should be given to panels: if a panel is provided with a status of R then all [[Lab Result]] entries previously stored for the corresponding [[Lab Report]] will be marked as deleted, regardless of whether they were previously included in the panel being redacted or whether they are provided in the current message. If the message contains multiple panels where some but not all have a status of R, then PKB will first delete all results associated with the report ID before following the usual create or update workflow for lab results provided in panels that do not have a status of R.

When not matched: New [[Lab Report]] created.

[[Lab Result]]

Matched on: Results are matched on the test ID (OBX-3, or OBR-4 for textual reports). The test ID is matched only on the first and third components (code and code system), and matching is case sensitive.

When matched: If PKB detects a meaningful difference between the provided and existing lab result content, then the existing [[Lab Result]] is replaced in its entirety with the values provided in this message. A partial update is not performed.

Note: that the existence of more than one version of a given lab result is what determines whether PKB displays a correction indicator in the web interface. The correction indicator is not driven by the status value declared by the sender (e.g. OBX-11), and sending more than one message for a given lab order is not guaranteed to trigger the correction indicator since PKB dedupes updates that do not meaningfully change the content of the lab result.

When not matched: New [[Lab Result]] created.

[[Local Test Type]]

Matched on: The test type is identified by the Source Organisation (to ensure no namespace clashes) along with test code, test coding system and units (all matched case sensitively).

When matched: If an existing [[Local Test Type]] is found, it will be updated with the latest Test Name if it differs from what is currently stored. In this way, callers are able to update the display name for their local test types.

When not matched: A new [[Local Test Type]] is created.

[[Measurement Report]]

Matched on: [[Measurement Report.External ID]] as derived from ORC-3.1 or OBR-3.1

When matched: Unlike lab results, measurements in a report are not individually matched for corrections. However, similar to lab reports, if a panel has status R, then any measurements with a matching report ID will be deleted.

When not matched: New [[Measurement Report]] created.

[[Measurement]]

Matched on: There is no unique identifier on a [[Measurement]] submitted via HL7, so they cannot be updated individually.

When matched: N/A

When not matched: New [[Measurement]] created.